| Crescent City Psychological Services Llc | |
|
137 N Clark St New Orleans LA 70119-5244 | |
| (504) 481-2099 | |
| (407) 567-7870 |
| Full Name | Crescent City Psychological Services Llc |
|---|---|
| Speciality | Psychologist |
| Location | 137 N Clark St, New Orleans, Louisiana |
| Authorized Official Name and Position | Mark Skellie (SOLE MEMBER) |
| Authorized Official Contact | 5044812099 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crescent City Psychological Services Llc 137 N Clark St New Orleans LA 70119-5244 Ph: (504) 481-2099 | Crescent City Psychological Services Llc 137 N Clark St New Orleans LA 70119-5244 Ph: (504) 481-2099 |
| NPI Number | 1518365790 |
|---|---|
| Provider Enumeration Date | 12/19/2014 |
| Last Update Date | 12/19/2014 |
| Medicare PECOS PAC ID | 7911221908 |
|---|---|
| Medicare Enrollment ID | O20150122001023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518365790 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 1190 (Louisiana) | Primary |
| Provider Name | Mark A Skellie |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1265733851 PECOS PAC ID: 6204091382 Enrollment ID: I20120625000224 |
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