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SELF REALIZATION, LLC

Health Service

A psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974).

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Contact Information

SELF REALIZATION, LLC
102 SLEEPY HOLLOW DR
STE 200
MIDDLETOWN, DE  19709-5841
 Phone: 302-312-8221
 Fax:
 Website:
 

Specialty

 Taxonomy Code Specialty Code Provider Type

Health Service

 103TH0100X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for SELF REALIZATION, LLC

NPI # 1487982880
LBN Legal business name SELF REALIZATION, LLC
Authorized official EARL WALKER - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 11/23/2009
Last updated 02/04/2010 - About 16 years ago
Identifiers
DE License # B10000757
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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