| Max Psychiatry Pc | |
|
6402 Mccrimmon Pkwy Suite - 200 Morrisville NC 27560-8138 | |
| (919) 386-0402 | |
| Not Available |
| Full Name | Max Psychiatry Pc |
|---|---|
| Speciality | Psychologist |
| Location | 6402 Mccrimmon Pkwy, Morrisville, North Carolina |
| Authorized Official Name and Position | Saman Hasan (PRESIDENT) |
| Authorized Official Contact | 9193860402 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Max Psychiatry Pc 6402 Mccrimmon Pkwy Suite - 200 Morrisville NC 27560-8138 Ph: () - | Max Psychiatry Pc 6402 Mccrimmon Pkwy Suite - 200 Morrisville NC 27560-8138 Ph: (919) 386-0402 |
| NPI Number | 1619231776 |
|---|---|
| Provider Enumeration Date | 07/03/2012 |
| Last Update Date | 07/03/2012 |
| Medicare PECOS PAC ID | 9931365343 |
|---|---|
| Medicare Enrollment ID | O20120730000064 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619231776 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP0016X | Psychologist - Prescribing (medical) | (* (Not Available)) | Primary |
| Provider Name | Kristy K Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639282676 PECOS PAC ID: 7416054440 Enrollment ID: I20070525000197 |
| Provider Name | Virginia C Tysinger |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1033242821 PECOS PAC ID: 3072602606 Enrollment ID: I20071205000308 |
| Provider Name | Dorine Henrietta Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093811705 PECOS PAC ID: 1153456389 Enrollment ID: I20100312000908 |
| Provider Name | Robin Lynn Cassidy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215968789 PECOS PAC ID: 7517139413 Enrollment ID: I20111019000646 |
| Provider Name | Saman Hasan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871793893 PECOS PAC ID: 0840456257 Enrollment ID: I20120730000077 |
| Provider Name | Lori Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316467749 PECOS PAC ID: 4385916154 Enrollment ID: I20170815001687 |
| Provider Name | Constance Lazakis Marquette |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306219621 PECOS PAC ID: 4385065960 Enrollment ID: I20200608001030 |
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