Provider Demographics
NPI:1851870778
Name:PSYCARE LLC
Entity Type:Organization
Organization Name:PSYCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RADWAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KHURI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-237-7701
Mailing Address - Street 1:PO BOX 38598
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38183-0598
Mailing Address - Country:US
Mailing Address - Phone:901-480-8225
Mailing Address - Fax:901-234-0152
Practice Address - Street 1:8356 SILVERWIND DR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38125-0767
Practice Address - Country:US
Practice Address - Phone:901-480-8225
Practice Address - Fax:901-234-0152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-10
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12489103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty