| Premier Psychological Services, Llc | |
|
610 N Ridge St Danville VA 24541-1042 | |
| (434) 280-8939 | |
| (434) 305-1086 |
| Full Name | Premier Psychological Services, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 610 N Ridge St, Danville, Virginia |
| Authorized Official Name and Position | Christopher L. Cousins (CEO / HEAD CLINICIAL PSYCHOLOGIST) |
| Authorized Official Contact | 4342808939 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Psychological Services, Llc 610 N Ridge St Danville VA 24541-1042 Ph: (434) 280-8939 | Premier Psychological Services, Llc 610 N Ridge St Danville VA 24541-1042 Ph: (434) 280-8939 |
| NPI Number | 1295494565 |
|---|---|
| Provider Enumeration Date | 12/14/2021 |
| Last Update Date | 04/11/2022 |
| Certification Date | 04/11/2022 |
| Medicare PECOS PAC ID | 6103218441 |
|---|---|
| Medicare Enrollment ID | O20220119002023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295494565 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Christopher Cousins |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871801092 PECOS PAC ID: 5597920678 Enrollment ID: I20120625000200 |
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