| Awakenings Psychiatric Services, Pc | |
|
1010 E North St Ste 1a Greenville SC 29601-3166 | |
| (864) 777-3039 | |
| (864) 400-9714 |
| Full Name | Awakenings Psychiatric Services, Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1010 E North St Ste 1a, Greenville, South Carolina |
| Authorized Official Name and Position | Peter Longstreet (PRESIDENT) |
| Authorized Official Contact | 8647773039 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Awakenings Psychiatric Services, Pc 1010 E North St Ste 1a Greenville SC 29601-3166 Ph: (864) 777-3039 | Awakenings Psychiatric Services, Pc 1010 E North St Ste 1a Greenville SC 29601-3166 Ph: (864) 777-3039 |
| NPI Number | 1518591858 |
|---|---|
| Provider Enumeration Date | 02/25/2020 |
| Last Update Date | 05/16/2020 |
| Certification Date | 05/16/2020 |
| Medicare PECOS PAC ID | 2365871456 |
|---|---|
| Medicare Enrollment ID | O20200413001455 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518591858 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Anusuiya Nagar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689934002 PECOS PAC ID: 5799915211 Enrollment ID: I20170913000651 |
| Provider Name | Peter Leigh Longstreet |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366573990 PECOS PAC ID: 9931234374 Enrollment ID: I20190523002873 |
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