| Salem Psychological Services Llc | |
|
325 13th St Ne Ste 502 Salem OR 97301-2203 | |
| (503) 581-2351 | |
| (503) 581-0125 |
| Full Name | Salem Psychological Services Llc |
|---|---|
| Speciality | Psychologist |
| Location | 325 13th St Ne Ste 502, Salem, Oregon |
| Authorized Official Name and Position | James Patrick Mooney (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 5035812351 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Salem Psychological Services Llc 325 13th St Ne Ste 502 Salem OR 97301-2203 Ph: (503) 581-2351 | Salem Psychological Services Llc 325 13th St Ne Ste 502 Salem OR 97301-2203 Ph: (503) 581-2351 |
| NPI Number | 1063917870 |
|---|---|
| Provider Enumeration Date | 03/26/2018 |
| Last Update Date | 03/26/2018 |
| Medicare PECOS PAC ID | 1052668050 |
|---|---|
| Medicare Enrollment ID | O20180723001555 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063917870 | NPI | - | NPPES |
| 1629134531 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | OR1088 (Oregon) | Primary |
| Provider Name | James P Mooney |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629134531 PECOS PAC ID: 8820007545 Enrollment ID: I20060407000259 |
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