Provider Demographics
NPI:1467225953
Name:SYCAMORE PSYCHIATRY
Entity Type:Organization
Organization Name:SYCAMORE PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARRISH
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:662-301-8683
Mailing Address - Street 1:110 COURT ST STE A
Mailing Address - Street 2:
Mailing Address - City:SENATOBIA
Mailing Address - State:MS
Mailing Address - Zip Code:38668-2635
Mailing Address - Country:US
Mailing Address - Phone:662-301-8683
Mailing Address - Fax:662-301-8684
Practice Address - Street 1:110 COURT ST STE A
Practice Address - Street 2:
Practice Address - City:SENATOBIA
Practice Address - State:MS
Practice Address - Zip Code:38668-2635
Practice Address - Country:US
Practice Address - Phone:662-301-8683
Practice Address - Fax:662-301-8684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)