| Geriatric Psychology Affiliates Llc | |
|
118 Maupin Cir Shelbyville TN 37160-3781 | |
| (615) 948-1970 | |
| (615) 536-4346 |
| Full Name | Geriatric Psychology Affiliates Llc |
|---|---|
| Speciality | Psychologist |
| Location | 118 Maupin Cir, Shelbyville, Tennessee |
| Authorized Official Name and Position | Lisa North (OWNER) |
| Authorized Official Contact | 6159481970 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Geriatric Psychology Affiliates Llc 118 Maupin Cir Shelbyville TN 37160-3781 Ph: (615) 948-1970 | Geriatric Psychology Affiliates Llc 118 Maupin Cir Shelbyville TN 37160-3781 Ph: (615) 948-1970 |
| NPI Number | 1417483421 |
|---|---|
| Provider Enumeration Date | 05/11/2017 |
| Last Update Date | 05/11/2017 |
| Medicare PECOS PAC ID | 0244506251 |
|---|---|
| Medicare Enrollment ID | O20171018003590 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417483421 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Robert M North |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1548291370 PECOS PAC ID: 4587565957 Enrollment ID: I20090330000075 |
| Provider Name | Glenn Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1710391719 PECOS PAC ID: 8426321639 Enrollment ID: I20170911002086 |
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Geriatric Psychology Affiliates Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 118 Maupin Cir, Shelbyville, TN 37160 Phone: 931-580-8936 |