Provider Demographics
NPI:1508629619
Name:PSYCH NERDS, LLC
Entity Type:Organization
Organization Name:PSYCH NERDS, LLC
Other - Org Name:PSYCHNERD LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARMSTRONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-391-4668
Mailing Address - Street 1:8415 SHADYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74131-3881
Mailing Address - Country:US
Mailing Address - Phone:620-391-4668
Mailing Address - Fax:
Practice Address - Street 1:8415 SHADYWOOD DR
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74131-3881
Practice Address - Country:US
Practice Address - Phone:620-391-4668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-01
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)