| Dedicated Psychiatric Services, Pllc | |
|
1944 Brookside Dr Ste 3 Kingsport TN 37660-4618 | |
| (423) 366-6013 | |
| Not Available |
| Full Name | Dedicated Psychiatric Services, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1944 Brookside Dr Ste 3, Kingsport, Tennessee |
| Authorized Official Name and Position | Angel M Smith (PMHNP-BC/ PRESIDENT) |
| Authorized Official Contact | 4233666013 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dedicated Psychiatric Services, Pllc 1944 Brookside Dr Ste 3 Kingsport TN 37660-4618 Ph: (423) 366-6013 | Dedicated Psychiatric Services, Pllc 1944 Brookside Dr Ste 3 Kingsport TN 37660-4618 Ph: (423) 366-6013 |
| NPI Number | 1346927589 |
|---|---|
| Provider Enumeration Date | 06/29/2023 |
| Last Update Date | 06/29/2023 |
| Certification Date | 06/29/2023 |
| Medicare PECOS PAC ID | 5294197323 |
|---|---|
| Medicare Enrollment ID | O20230821003793 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346927589 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Angel Michelle Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619439908 PECOS PAC ID: 5496086662 Enrollment ID: I20230822002006 |
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