| Psylin, Inc. | |
|
22901 S Ridgeview Dr Peculiar MO 64078-0195 | |
| (417) 321-4881 | |
| (866) 223-4072 |
| Full Name | Psylin, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 22901 S Ridgeview Dr, Peculiar, Missouri |
| Authorized Official Name and Position | Christopher Carlin (PRESIDENT) |
| Authorized Official Contact | 4173214881 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psylin, Inc. 22901 S Ridgeview Dr Peculiar MO 64078-0195 Ph: (417) 321-4881 | Psylin, Inc. 22901 S Ridgeview Dr Peculiar MO 64078-0195 Ph: (417) 321-4881 |
| NPI Number | 1265735294 |
|---|---|
| Provider Enumeration Date | 12/14/2010 |
| Last Update Date | 07/31/2024 |
| Certification Date | 07/31/2024 |
| Medicare PECOS PAC ID | 2769662337 |
|---|---|
| Medicare Enrollment ID | O20110215000056 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265735294 | NPI | - | NPPES |
| 11461940 | Other | CAQH # | |
| MA3108 | Other | MO | MEDICARE PTAN |
| 1265735294 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 2001014377 (Missouri) | Primary |
| Provider Name | Christopher J Carlin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740264241 PECOS PAC ID: 7113074766 Enrollment ID: I20090416000532 |
Overcomers Counseling Center Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 17101 East 203rd St, Peculiar, MO 64078 Phone: 816-255-5375 |