| Princeton Psychological Llc | |
|
321 Rogers St Princeton WV 24740-3639 | |
| (304) 308-3819 | |
| Not Available |
| Full Name | Princeton Psychological Llc |
|---|---|
| Speciality | Psychologist |
| Location | 321 Rogers St, Princeton, West Virginia |
| Authorized Official Name and Position | Mary Jo Cecil (OWNER) |
| Authorized Official Contact | 3043083819 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Princeton Psychological Llc Po Box 5509 Princeton WV 24740-5509 Ph: (304) 308-3819 | Princeton Psychological Llc 321 Rogers St Princeton WV 24740-3639 Ph: (304) 308-3819 |
| NPI Number | 1144832528 |
|---|---|
| Provider Enumeration Date | 08/18/2020 |
| Last Update Date | 08/19/2020 |
| Certification Date | 08/19/2020 |
| Medicare PECOS PAC ID | 7416338124 |
|---|---|
| Medicare Enrollment ID | O20220712004142 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144832528 | NPI | - | NPPES |
| 1063067882 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Mary Jo Cecil |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063067882 PECOS PAC ID: 8325429038 Enrollment ID: I20220712004163 |
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