Psychiatric Center Llc | |
324 W Hale St Lake Charles LA 70601-8439 | |
(337) 433-9177 | |
(337) 433-9173 |
Full Name | Psychiatric Center Llc |
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Speciality | Psychiatry & Neurology |
Location | 324 W Hale St, Lake Charles, Louisiana |
Authorized Official Name and Position | Ehtesham U Syed (OWNER) |
Authorized Official Contact | 3374339177 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Psychiatric Center Llc 324 W Hale St Lake Charles LA 70601-8439 Ph: (337) 433-9177 | Psychiatric Center Llc 324 W Hale St Lake Charles LA 70601-8439 Ph: (337) 433-9177 |
NPI Number | 1104156967 |
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Provider Enumeration Date | 12/30/2009 |
Last Update Date | 04/24/2019 |
Medicare PECOS PAC ID | 0749312742 |
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Medicare Enrollment ID | O20100709000150 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104156967 | NPI | - | NPPES |
1823694 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
Provider Name | Aneeta Afzal |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1396727335 PECOS PAC ID: 2961539317 Enrollment ID: I20100416000397 |
Provider Name | Sattaria S Dilks |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922067131 PECOS PAC ID: 6204022262 Enrollment ID: I20101202000385 |
Provider Name | Suzanne M Creel |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1912966128 PECOS PAC ID: 5991992604 Enrollment ID: I20101207001091 |
Provider Name | Sarah Newman Walker |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1760825152 PECOS PAC ID: 5597992354 Enrollment ID: I20131226001326 |
Provider Name | Christy E Smith |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1053787192 PECOS PAC ID: 6709194251 Enrollment ID: I20151001002554 |
Provider Name | Lindsey Bufford |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497131379 PECOS PAC ID: 3476861808 Enrollment ID: I20151003000092 |
Provider Name | Cain Christopher Schexneider |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1588147276 PECOS PAC ID: 7719230986 Enrollment ID: I20181106000492 |
Provider Name | Adrian Cale Brouillette |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902389497 PECOS PAC ID: 6103161393 Enrollment ID: I20181217000920 |
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