| Organization Name: | PIEDMONT PSYCHOLOGICAL SERVICES |
| NPI Number: | 1104120294 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LYNN CARSON BLACKWOOD (LICENSED CLINICAL PSYCHOLOGIST) |
| Mailing Address: | 200b Milnwood Rd Farmville |
| State: | VA US |
| Postal Code: | 239012817 |
| Phone Number: | 4343158813 |
| Fax Number: | 4343155913 |
| NPI Enumeration Date: | 01/04/2011 |
| NPI Last Update Date: | 01/04/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 0701003954 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |