| Psycamore Llc | |
|
7165 Getwell Rd Southaven MS 38672-9618 | |
| (662) 349-2818 | |
| Not Available |
| Full Name | Psycamore Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 7165 Getwell Rd, Southaven, Mississippi |
| Authorized Official Name and Position | Carol Ann Williams (ADULT CLINICAL MANGER) |
| Authorized Official Contact | 6623492818 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Psycamore Llc 7165 Getwell Rd Southaven MS 38672-9618 Ph: (662) 349-2818 | Psycamore Llc 7165 Getwell Rd Southaven MS 38672-9618 Ph: (662) 349-2818 |
| NPI Number | 1770886012 |
|---|---|
| Provider Enumeration Date | 12/08/2010 |
| Last Update Date | 12/08/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770886012 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | LPC 1510 (Mississippi) | Primary |
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