| Fresh Focus Psychiatric Services Pllc | |
|
825 Davis St Ste D Blacksburg VA 24060-7009 | |
| (304) 887-7284 | |
| Not Available |
| Full Name | Fresh Focus Psychiatric Services Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 825 Davis St Ste D, Blacksburg, Virginia |
| Authorized Official Name and Position | Kelly Thomas (DOCTOR) |
| Authorized Official Contact | 5403064359 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fresh Focus Psychiatric Services Pllc 825 Davis St Ste D Blacksburg VA 24060-7009 Ph: (540) 306-4359 | Fresh Focus Psychiatric Services Pllc 825 Davis St Ste D Blacksburg VA 24060-7009 Ph: (304) 887-7284 |
| NPI Number | 1083237747 |
|---|---|
| Provider Enumeration Date | 05/28/2020 |
| Last Update Date | 07/14/2020 |
| Certification Date | 07/14/2020 |
| Medicare PECOS PAC ID | 3870919145 |
|---|---|
| Medicare Enrollment ID | O20200922003182 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083237747 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Kelly Denise Thomas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275894420 PECOS PAC ID: 3072809011 Enrollment ID: I20200922003224 |
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