| Inspire Psychological Center, Llc | |
|
632 Coffeen Ave Sheridan NY 82801 | |
| (307) 655-5510 | |
| Not Available |
| Full Name | Inspire Psychological Center, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 632 Coffeen Ave, Sheridan, New York |
| Authorized Official Name and Position | Vivianne Lemos Tran (OWNER) |
| Authorized Official Contact | 3076799057 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Inspire Psychological Center, Llc 632 Coffeen Ave Sheridan WY 82801-5314 Ph: (307) 655-5510 | Inspire Psychological Center, Llc 632 Coffeen Ave Sheridan NY 82801 Ph: (307) 655-5510 |
| NPI Number | 1962882233 |
|---|---|
| Provider Enumeration Date | 06/02/2015 |
| Last Update Date | 05/10/2016 |
| Medicare PECOS PAC ID | 8123311644 |
|---|---|
| Medicare Enrollment ID | O20160721000622 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962882233 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Sandra L Natwick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679792634 PECOS PAC ID: 3375573520 Enrollment ID: I20190221002235 |
| Provider Name | David J Koehn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700217429 PECOS PAC ID: 4385866813 Enrollment ID: I20201030000507 |
| Provider Name | David A Carlson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255539060 PECOS PAC ID: 4789093931 Enrollment ID: I20210429002050 |