Organization Name: | PSYCHOLOGICAL GROWTH SERVICES, LLC |
NPI Number: | 1255592531 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAMI M MESSINA (LICENSED PSYCHOLOGIST) |
Mailing Address: | 157 Eagle Rock Ave Roseland |
State: | NJ US |
Postal Code: | 070681353 |
Phone Number: | 9739519479 |
Fax Number: | |
NPI Enumeration Date: | 06/19/2008 |
NPI Last Update Date: | 06/19/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC1900X |
License Number: | 35S100432000 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Counseling |
Taxonomy Definition: |