Provider Demographics
NPI:1689640468
Name:PSYCH SERVICES LLC
Entity Type:Organization
Organization Name:PSYCH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:D
Authorized Official - Last Name:WHITTEN
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:615-794-1814
Mailing Address - Street 1:PO BOX 681345
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37068-1345
Mailing Address - Country:US
Mailing Address - Phone:615-794-1814
Mailing Address - Fax:615-372-0471
Practice Address - Street 1:1614 WELLINGTON GRN
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-5359
Practice Address - Country:US
Practice Address - Phone:615-794-1814
Practice Address - Fax:615-372-0471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-23
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3374681Medicaid
TN3374681Medicaid