Provider Demographics
NPI:1770350316
Name:CONNECT PSYCHIATRY LLC
Entity type:Organization
Organization Name:CONNECT PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NURSE PRACTITIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRANTLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CATLETTE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:662-233-9033
Mailing Address - Street 1:2686 W OXFORD LOOP STE 125
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-5427
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2686 W OXFORD LOOP STE 125
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-5427
Practice Address - Country:US
Practice Address - Phone:662-233-9033
Practice Address - Fax:662-233-9043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)