| Psychiatric Associates Inc | |
|
6406 N Santa Fe Ave Ste A Oklahoma City OK 73116-9117 | |
| (405) 840-3793 | |
| (405) 840-3794 |
| Full Name | Psychiatric Associates Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 6406 N Santa Fe Ave Ste A, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Fay Mitchell (OFFICE MANAGER) |
| Authorized Official Contact | 4058403793 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychiatric Associates Inc 6406 N Santa Fe Ave Ste A Oklahoma City OK 73116-9117 Ph: (405) 840-3793 | Psychiatric Associates Inc 6406 N Santa Fe Ave Ste A Oklahoma City OK 73116-9117 Ph: (405) 840-3793 |
| NPI Number | 1205893674 |
|---|---|
| Provider Enumeration Date | 04/28/2006 |
| Last Update Date | 07/15/2022 |
| Certification Date | 07/15/2022 |
| Medicare PECOS PAC ID | 2264334671 |
|---|---|
| Medicare Enrollment ID | O20040126000426 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205893674 | NPI | - | NPPES |
| 100740060A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Maryellen L Dodd |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831176916 PECOS PAC ID: 3476532326 Enrollment ID: I20060615000031 |
| Provider Name | Karen K Ross |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790753952 PECOS PAC ID: 1052573896 Enrollment ID: I20120424000505 |
| Provider Name | John Rahhal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164490223 PECOS PAC ID: 2365468188 Enrollment ID: I20150123000425 |
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