| Psychiatric Solutions Clinic Llc | |
|
3430 E Flamingo Rd Ste 100 Las Vegas NV 89121-5018 | |
| (702) 444-4690 | |
| (702) 444-0977 |
| Full Name | Psychiatric Solutions Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3430 E Flamingo Rd Ste 100, Las Vegas, Nevada |
| Authorized Official Name and Position | Oluyemisi Olayinka Adedotun (OWNER) |
| Authorized Official Contact | 7024444690 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychiatric Solutions Clinic Llc 3430 E Flamingo Rd Ste 100 Las Vegas NV 89121-5018 Ph: (702) 444-4690 | Psychiatric Solutions Clinic Llc 3430 E Flamingo Rd Ste 100 Las Vegas NV 89121-5018 Ph: (702) 444-4690 |
| NPI Number | 1780059352 |
|---|---|
| Provider Enumeration Date | 12/08/2015 |
| Last Update Date | 10/18/2022 |
| Certification Date | 10/18/2022 |
| Medicare PECOS PAC ID | 9931508280 |
|---|---|
| Medicare Enrollment ID | O20210519000700 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780059352 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 2002233062101 (Nevada) | Primary |
| Provider Name | Oluyemisi O Adedotun |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629393632 PECOS PAC ID: 2264621705 Enrollment ID: I20120724000062 |
| Provider Name | Ruth F Ramirez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386731651 PECOS PAC ID: 2769675495 Enrollment ID: I20130603000274 |
| Provider Name | Teodora B Del Pilar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992195523 PECOS PAC ID: 5890096481 Enrollment ID: I20151228001143 |
| Provider Name | Elsie Creason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033611793 PECOS PAC ID: 9133541188 Enrollment ID: I20200629003755 |
| Provider Name | Edwige Hermine Fandio Ngankou |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720865272 PECOS PAC ID: 9739538240 Enrollment ID: I20231208003156 |
| Provider Name | Emmanuel T Onyeani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194215673 PECOS PAC ID: 0244639516 Enrollment ID: I20240612003557 |
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