Provider Demographics
NPI:1174343107
Name:TSE PSYCHOLOGICAL SERVICES LLC
Entity type:Organization
Organization Name:TSE PSYCHOLOGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMIKA
Authorized Official - Middle Name:SHERELL
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:314-270-2343
Mailing Address - Street 1:PO BOX 430175
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63143-0275
Mailing Address - Country:US
Mailing Address - Phone:314-270-2343
Mailing Address - Fax:
Practice Address - Street 1:7110 OAKLAND AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117-1868
Practice Address - Country:US
Practice Address - Phone:314-270-2343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty