| Freedom Psychiatry Services Pllc | |
|
7540 Ramble Way Ste 109 Raleigh NC 27616-4318 | |
| (919) 457-1200 | |
| (919) 457-1100 |
| Full Name | Freedom Psychiatry Services Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 7540 Ramble Way Ste 109, Raleigh, North Carolina |
| Authorized Official Name and Position | Kondal Madaram (PRESIDENT) |
| Authorized Official Contact | 9192716784 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Freedom Psychiatry Services Pllc 7540 Ramble Way Ste 109 Raleigh NC 27616-4318 Ph: (919) 457-1100 | Freedom Psychiatry Services Pllc 7540 Ramble Way Ste 109 Raleigh NC 27616-4318 Ph: (919) 457-1200 |
| NPI Number | 1699279448 |
|---|---|
| Provider Enumeration Date | 03/19/2018 |
| Last Update Date | 09/17/2024 |
| Certification Date | 09/17/2024 |
| Medicare PECOS PAC ID | 9931442704 |
|---|---|
| Medicare Enrollment ID | O20190517001339 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699279448 | NPI | - | NPPES |
| 2015-01900 | Other | NC | NORTH CAROLINA MEDICAL BOARD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Katrina Mccourt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063810711 PECOS PAC ID: 5799098356 Enrollment ID: I20150725012649 |
| Provider Name | Kondal Rao Madaram |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003952144 PECOS PAC ID: 4284826892 Enrollment ID: I20160718001619 |
| Provider Name | Charnissa Nicole Batts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346804739 PECOS PAC ID: 3678809225 Enrollment ID: I20190719002110 |
| Provider Name | Rubi Baltazar Merino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487280939 PECOS PAC ID: 7517376320 Enrollment ID: I20210507000929 |
| Provider Name | Susan Dumire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285230169 PECOS PAC ID: 4587064837 Enrollment ID: I20210608003724 |
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