Provider Demographics
NPI:1083951164
Name:PSYCHIATRIC CENTER INC
Entity Type:Organization
Organization Name:PSYCHIATRIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:MULLINS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:606-432-7233
Mailing Address - Street 1:PO BOX 2470
Mailing Address - Street 2:1330 SOUTH MAYO TRAIL STE 301
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41502-2470
Mailing Address - Country:US
Mailing Address - Phone:606-432-7233
Mailing Address - Fax:606-432-7255
Practice Address - Street 1:1330 S MAYO TRL STE 301
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-2321
Practice Address - Country:US
Practice Address - Phone:606-432-7233
Practice Address - Fax:606-432-7255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-10
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0323372364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, AdultGroup - Single Specialty