| Phoenixpsychologicalservices Inc | |
|
1930 Turkey Point Rd North East MD 21901-5452 | |
| (410) 287-4744 | |
| (443) 403-0364 |
| Full Name | Phoenixpsychologicalservices Inc |
|---|---|
| Speciality | Counselor |
| Location | 1930 Turkey Point Rd, North East, Maryland |
| Authorized Official Name and Position | Charla R Scheidle (OWNER/CEO) |
| Authorized Official Contact | 4102874744 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenixpsychologicalservices Inc 1930 Turkey Point Rd North East MD 21901-5452 Ph: (410) 287-4744 | Phoenixpsychologicalservices Inc 1930 Turkey Point Rd North East MD 21901-5452 Ph: (410) 287-4744 |
| NPI Number | 1265725733 |
|---|---|
| Provider Enumeration Date | 05/17/2011 |
| Last Update Date | 04/18/2016 |
| Medicare PECOS PAC ID | 7214114842 |
|---|---|
| Medicare Enrollment ID | O20110608000680 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265725733 | NPI | - | NPPES |
| 402020100 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | R070399 (Maryland) | Primary |
| Provider Name | Charla R Scheidle |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1053480913 PECOS PAC ID: 8628255254 Enrollment ID: I20110609000794 |
| Provider Name | Laurie E Scheidle |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1801184171 PECOS PAC ID: 4486826849 Enrollment ID: I20111006000317 |
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