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Contact Information

YMG PSYCHOLOGICAL SERVICES, PLLC
701 DEVONSHIRE DR. BLD. C SUITE 132
CHAMPAIGN, IL61820
 Phone: 217-278-0159
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for YMG PSYCHOLOGICAL SERVICES, PLLC

NPI # 1629787239
LBN Legal business name YMG PSYCHOLOGICAL SERVICES, PLLC
Authorized official DYNESHA MASON GRISSOM - (OWNER/PSYCHOLOGIST)
Entity Organization
Organization subpart 1 No
Enumeration date 11/22/2022
Last updated 11/22/2022 - About 4 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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