| Csp Psychiatry Llc | |
|
4505 Pine Tree Cir Ste 201 Vestavia AL 35243-2380 | |
| (205) 453-4325 | |
| Not Available |
| Full Name | Csp Psychiatry Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4505 Pine Tree Cir Ste 201, Vestavia, Alabama |
| Authorized Official Name and Position | Kristen Aycock (BILLER /CREDENTIALING) |
| Authorized Official Contact | 2059681227 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Csp Psychiatry Llc 4505 Pine Tree Cir Ste 201 Vestavia AL 35243-2380 Ph: (205) 453-4325 | Csp Psychiatry Llc 4505 Pine Tree Cir Ste 201 Vestavia AL 35243-2380 Ph: (205) 453-4325 |
| NPI Number | 1225672058 |
|---|---|
| Provider Enumeration Date | 11/05/2019 |
| Last Update Date | 11/05/2019 |
| Medicare PECOS PAC ID | 1658706874 |
|---|---|
| Medicare Enrollment ID | O20200116001740 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225672058 | NPI | - | NPPES |
| 149766 | Medicaid | AL | |
| 150612 | Medicaid | AL | |
| 150204 | Medicaid | AL | |
| 09320028 | Medicaid | MS | |
| 149645 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Cayce Paddock |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740424159 PECOS PAC ID: 3072759877 Enrollment ID: I20130712000365 |
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