Provider Demographics
NPI:1225365331
Name:FAMILY PSYCH SERVICES, PLLC
Entity Type:Organization
Organization Name:FAMILY PSYCH SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:REENA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CAMOENS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-228-2381
Mailing Address - Street 1:921 RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37206-3714
Mailing Address - Country:US
Mailing Address - Phone:615-228-2381
Mailing Address - Fax:615-228-2625
Practice Address - Street 1:921 RUSSELL ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37206-3714
Practice Address - Country:US
Practice Address - Phone:615-228-2381
Practice Address - Fax:615-228-2625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-10
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD00000265382084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3845344Medicaid
G30147Medicare UPIN