Provider Demographics
NPI:1215643028
Name:MY PSYCH HEALTH LLC
Entity type:Organization
Organization Name:MY PSYCH HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MOHD DZAIDI
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHD DAUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-353-2368
Mailing Address - Street 1:825 HIGHWAY 71 N
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:AR
Mailing Address - Zip Code:72921-5114
Mailing Address - Country:US
Mailing Address - Phone:479-632-6688
Mailing Address - Fax:
Practice Address - Street 1:825 HIGHWAY 71 N
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:AR
Practice Address - Zip Code:72921-5114
Practice Address - Country:US
Practice Address - Phone:479-632-6688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MY PSYCH HEALTH LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-01-25
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty