| Petit Psychiatry | |
|
6801 Lake Worth Rd Ste 213 Greenacres FL 33467-2966 | |
| (561) 576-7879 | |
| (866) 450-1704 |
| Full Name | Petit Psychiatry |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 6801 Lake Worth Rd Ste 213, Greenacres, Florida |
| Authorized Official Name and Position | Ebony Davis (PRESIDENT) |
| Authorized Official Contact | 2052005110 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Petit Psychiatry 6801 Lake Worth Rd Ste 213 Greenacres FL 33467-2966 Ph: (561) 576-7879 | Petit Psychiatry 6801 Lake Worth Rd Ste 213 Greenacres FL 33467-2966 Ph: (561) 576-7879 |
| NPI Number | 1982313508 |
|---|---|
| Provider Enumeration Date | 11/22/2022 |
| Last Update Date | 05/19/2024 |
| Certification Date | 05/19/2024 |
| Medicare PECOS PAC ID | 6002272358 |
|---|---|
| Medicare Enrollment ID | O20230511003452 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982313508 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Ebony Davis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447695184 PECOS PAC ID: 1850534991 Enrollment ID: I20190207000836 |
| Provider Name | Allison Mclean |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528507514 PECOS PAC ID: 9133661226 Enrollment ID: I20240604003345 |
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