Provider Demographics
NPI:1386213684
Name:PSYCHED SOLUTIONS P.A.
Entity Type:Organization
Organization Name:PSYCHED SOLUTIONS P.A.
Other - Org Name:ANGELA C. BRINSON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:C
Authorized Official - Last Name:BRINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-257-7473
Mailing Address - Street 1:18425 NW 2ND AVE
Mailing Address - Street 2:5TH FLOOR PH 13
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-4524
Mailing Address - Country:US
Mailing Address - Phone:305-684-1390
Mailing Address - Fax:877-478-5333
Practice Address - Street 1:5245 W IRLO BRONSON MEMORIAL HWY UNIT 1
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34746-5347
Practice Address - Country:US
Practice Address - Phone:305-684-1390
Practice Address - Fax:877-478-5333
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PSYCHED SOLUTIONS P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101720000Medicaid