Provider Demographics
NPI:1669083002
Name:SEARCY PEDIATRIC AND ADOLESCENT BEHAVIORAL HEALTHCARE, LLC
Entity type:Organization
Organization Name:SEARCY PEDIATRIC AND ADOLESCENT BEHAVIORAL HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHILD/PEDIATRIC PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JASMIN
Authorized Official - Middle Name:S
Authorized Official - Last Name:SEARCY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:601-454-2082
Mailing Address - Street 1:1910 S INDIANA AVE APT 219
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-2915
Mailing Address - Country:US
Mailing Address - Phone:601-454-2082
Mailing Address - Fax:
Practice Address - Street 1:1 E ERIE ST STE 525
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2980
Practice Address - Country:US
Practice Address - Phone:312-471-3758
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty