Provider Demographics
NPI:1891733242
Name:PSYCHE IN MOTION, P.A.
Entity Type:Organization
Organization Name:PSYCHE IN MOTION, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARI
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHINAY-CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:785-840-9261
Mailing Address - Street 1:641 MISSOURI ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-2353
Mailing Address - Country:US
Mailing Address - Phone:785-840-9261
Mailing Address - Fax:785-840-9261
Practice Address - Street 1:641 MISSOURI ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-2353
Practice Address - Country:US
Practice Address - Phone:785-840-9261
Practice Address - Fax:785-840-9261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS74729363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS171004OtherBCBSKS BILLING PROVIDER
KS171004OtherBCBSKS BILLING PROVIDER