Provider Demographics
NPI:1659745107
Name:PSYCARE, LLC
Entity Type:Organization
Organization Name:PSYCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CARLISE
Authorized Official - Middle Name:CHERILYN
Authorized Official - Last Name:DOWNIE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CAP
Authorized Official - Phone:850-362-7400
Mailing Address - Street 1:151 MARY ESTHER BLVD
Mailing Address - Street 2:SUITE 307-A
Mailing Address - City:MARY ESTHER
Mailing Address - State:FL
Mailing Address - Zip Code:32569-1972
Mailing Address - Country:US
Mailing Address - Phone:850-362-7400
Mailing Address - Fax:
Practice Address - Street 1:151 MARY ESTHER BLVD
Practice Address - Street 2:SUITE 307-A
Practice Address - City:MARY ESTHER
Practice Address - State:FL
Practice Address - Zip Code:32569-1972
Practice Address - Country:US
Practice Address - Phone:850-362-7400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-20
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 117341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHRZ125ZOtherMEDICARE ID/PTAN