Provider Demographics
NPI:1245835339
Name:ICARE PSYCHIATRY & CONSULTING CORP
Entity type:Organization
Organization Name:ICARE PSYCHIATRY & CONSULTING CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:RENATA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEATHERSPOON
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:844-556-8550
Mailing Address - Street 1:828 LAKESHORE VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70461-6605
Mailing Address - Country:US
Mailing Address - Phone:504-300-4561
Mailing Address - Fax:
Practice Address - Street 1:1799 STUMPF BLVD STE 4B
Practice Address - Street 2:
Practice Address - City:TERRYTOWN
Practice Address - State:LA
Practice Address - Zip Code:70056-3950
Practice Address - Country:US
Practice Address - Phone:844-556-8550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty