Healthcare Provider Details

I. General information

NPI: 1073634341
Provider Name (Legal Business Name): PSYCHIATRIC CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 01/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 S MAYO TRL NOVA COMPLEX SUITE 301
PIKEVILLE KY
41501-2321
US

IV. Provider business mailing address

PO BOX 2470
PIKEVILLE KY
41502-2470
US

V. Phone/Fax

Practice location:
  • Phone: 606-432-7233
  • Fax: 606-432-7255
Mailing address:
  • Phone: 606-432-7233
  • Fax: 606-432-7255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number3002856
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. JAY VALLABH NAROLA
Title or Position: OWNER
Credential: MD
Phone: 606-432-7233