| Psimed, Inc. | |
|
3040 University Ave Morgantown WV 26505-3380 | |
| (301) 212-5526 | |
| (212) 241-5162 |
| Full Name | Psimed, Inc. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3040 University Ave, Morgantown, West Virginia |
| Authorized Official Name and Position | Terrence Eugene Rusin (PRESIDENT/CEO) |
| Authorized Official Contact | 3043448515 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psimed, Inc. Po Box 7310 Charleston WV 25356-0310 Ph: (304) 344-8515 | Psimed, Inc. 3040 University Ave Morgantown WV 26505-3380 Ph: (301) 212-5526 |
| NPI Number | 1932444221 |
|---|---|
| Provider Enumeration Date | 11/28/2012 |
| Last Update Date | 11/28/2012 |
| Medicare PECOS PAC ID | 9335199843 |
|---|---|
| Medicare Enrollment ID | O20050124000058 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932444221 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 23697 (West Virginia) | Primary |
| Provider Name | Kiran Shashi Devaraj |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003878984 PECOS PAC ID: 6204857105 Enrollment ID: I20051207000524 |
| Provider Name | Rachel J Sowards |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033296389 PECOS PAC ID: 8921132630 Enrollment ID: I20100817001047 |
| Provider Name | Nichole Lim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346562584 PECOS PAC ID: 5193917839 Enrollment ID: I20101013000178 |
| Provider Name | Michele L. Long |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295077220 PECOS PAC ID: 6305078635 Enrollment ID: I20140421000113 |
| Provider Name | Shanna N Akers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851825434 PECOS PAC ID: 2769750900 Enrollment ID: I20170613000599 |
| Provider Name | Brenda Jo Brubaker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700307519 PECOS PAC ID: 9032475637 Enrollment ID: I20171115001482 |
| Provider Name | Jawad Zafar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922427376 PECOS PAC ID: 9335367796 Enrollment ID: I20180423002097 |
| Provider Name | Cheri Call |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043706872 PECOS PAC ID: 7315296696 Enrollment ID: I20180926003383 |
| Provider Name | Alicia N Costabile |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235607524 PECOS PAC ID: 9436497310 Enrollment ID: I20190219002928 |
| Provider Name | Sheena Dohar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144618414 PECOS PAC ID: 9234432667 Enrollment ID: I20190319001641 |
| Provider Name | Hillard Patrick Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518499482 PECOS PAC ID: 9335425594 Enrollment ID: I20191112002515 |
| Provider Name | Trinity Nicholas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962868158 PECOS PAC ID: 1658783626 Enrollment ID: I20201215003337 |
| Provider Name | Melinda G Himstedt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417365065 PECOS PAC ID: 8022462902 Enrollment ID: I20230926003193 |
| Provider Name | Kimberly Erin Hotlosz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073993234 PECOS PAC ID: 9335599927 Enrollment ID: I20231222000018 |
| Provider Name | Catherine A Rasnake |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487971289 PECOS PAC ID: 4486099371 Enrollment ID: I20240301001164 |
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