Provider Demographics
| NPI: | 1023822699 |
|---|---|
| Name: | P.I.N.C. PSYCHIATRIC SERVICES, PLLC |
| Entity type: | Organization |
| Organization Name: | P.I.N.C. PSYCHIATRIC SERVICES, PLLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | OWNER |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | MARLENE |
| Authorized Official - Middle Name: | ANGELA |
| Authorized Official - Last Name: | BROWN |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | PMHNP-BC, APRN-CNP |
| Authorized Official - Phone: | 501-613-7863 |
| Mailing Address - Street 1: | 1327 N. SUNSET LANE |
| Mailing Address - Street 2: | |
| Mailing Address - City: | GUYMON |
| Mailing Address - State: | OK |
| Mailing Address - Zip Code: | 73942 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 501-613-7863 |
| Mailing Address - Fax: | 580-297-9105 |
| Practice Address - Street 1: | 212 NW 5TH ST |
| Practice Address - Street 2: | |
| Practice Address - City: | GUYMON |
| Practice Address - State: | OK |
| Practice Address - Zip Code: | 73942-4204 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 501-613-7863 |
| Practice Address - Fax: | 580-297-9105 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2025-02-04 |
| Last Update Date: | 2025-02-04 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psychiatric/Mental Health | Group - Single Specialty |
| No | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | ||
| No | 163W00000X | Nursing Service Providers | Registered Nurse | ||
| No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | |
| No | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health | |
| No | 251S00000X | Agencies | Community/Behavioral Health | ||
| No | 261QP2400X | Ambulatory Health Care Facilities | Clinic/Center | Prison Health | |
| No | 261QR1300X | Ambulatory Health Care Facilities | Clinic/Center | Rural Health | |
| No | 332BC3200X | Suppliers | Durable Medical Equipment & Medical Supplies | Customized Equipment | |
| No | 261QS1000X | Ambulatory Health Care Facilities | Clinic/Center | Student Health | |
| No | 332900000X | Suppliers | Non-Pharmacy Dispensing Site | ||
| No | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies | ||
| No | 347C00000X | Transportation Services | Private Vehicle | ||
| No | 332BN1400X | Suppliers | Durable Medical Equipment & Medical Supplies | Nursing Facility Supplies | |
| No | 343900000X | Transportation Services | Non-emergency Medical Transport (VAN) |
