Evan Ganick, is a
Clinic/center - Adult Mental Health based in Elmwood, Tennessee. Evan Ganick is licensed to practice in New York (license number 115656) and his current practice location is
89 Ouchonder Rd, Elmwood, Tennessee. He can be reached at his office (for appointments etc.) via phone at
(615) 579-6241.
NPI number for Evan Ganick is 1003562869 and his current mailing address is 89 Ouchonder Rd, Elmwood, Tennessee. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1003562869.
Healthcare Provider's Profile
| Full Name | Evan Ganick |
|---|
| Gender | Male |
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| Speciality | Clinic/center - Adult Mental Health |
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| Location | 89 Ouchonder Rd, Elmwood, Tennessee |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1003562869
- Provider Enumeration Date: 03/01/2022
- Last Update Date: 03/01/2022
Medical Identifiers
Medical identifiers for Evan Ganick such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1003562869 | NPI | - | NPPES |
| P-IND4MBYJ6QCTX-00 | Other | NY | NASW LIABILITY INSURANCE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1041C0700X | Social Worker - Clinical | 115656 (New York) | Secondary |
| 261QM0850X | Clinic/center - Adult Mental Health | 115656 (New York) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Evan Ganick is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Evan Ganick,
89 Ouchonder Rd,
Elmwood, TN 38560-4232
Ph: () - | Evan Ganick,
89 Ouchonder Rd,
Elmwood, TN 38560-4232
Ph: (615) 579-6241 |
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