Provider Demographics
NPI:1598770984
Name:PSYCH CARE ASSOC PC
Entity type:Organization
Organization Name:PSYCH CARE ASSOC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ASIMAH
Authorized Official - Middle Name:
Authorized Official - Last Name:QAYYUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-583-6750
Mailing Address - Street 1:85 POST OFFICE PARK STE 8501-B
Mailing Address - Street 2:
Mailing Address - City:WILBRAHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01095-1247
Mailing Address - Country:US
Mailing Address - Phone:413-583-6750
Mailing Address - Fax:833-974-2219
Practice Address - Street 1:85 POST OFFICE PARK STE 8501-B
Practice Address - Street 2:
Practice Address - City:WILBRAHAM
Practice Address - State:MA
Practice Address - Zip Code:01095-1247
Practice Address - Country:US
Practice Address - Phone:413-583-6750
Practice Address - Fax:833-974-2219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3024750Medicaid
MABCBS OF MAOtherM19012