Provider Demographics
NPI:1285179747
Name:THE PSYCH NETWORK
Entity Type:Organization
Organization Name:THE PSYCH NETWORK
Other - Org Name:KNOCKOUT MENTAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ORNELAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-547-3792
Mailing Address - Street 1:3085 E FLAMINGO RD
Mailing Address - Street 2:SUITE B-1
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-4308
Mailing Address - Country:US
Mailing Address - Phone:702-457-3792
Mailing Address - Fax:888-959-8990
Practice Address - Street 1:3085 E FLAMINGO RD
Practice Address - Street 2:SUITE B-1
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-4308
Practice Address - Country:US
Practice Address - Phone:702-457-3792
Practice Address - Fax:888-959-8990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-19
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health