Provider Demographics
NPI:1477508034
Name:PSYCHIATRIC SERVICES P C
Entity Type:Organization
Organization Name:PSYCHIATRIC SERVICES P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LLOYD
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:701-852-8798
Mailing Address - Street 1:1600 2ND AVE SW
Mailing Address - Street 2:SUITE 27
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58701-3459
Mailing Address - Country:US
Mailing Address - Phone:701-852-8798
Mailing Address - Fax:701-837-5410
Practice Address - Street 1:1600 2ND AVE SW
Practice Address - Street 2:SUITE 27
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-3459
Practice Address - Country:US
Practice Address - Phone:701-852-8798
Practice Address - Fax:701-837-5410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND466111501131101YM0800X
ND10103TC0700X
NDR20273163WP0808X
ND63412084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Not Answered163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Multi-Specialty
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND010500Medicaid
NDN70796Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER