Healthcare Provider Details

I. General information

NPI: 1972470177
Provider Name (Legal Business Name): PSYVO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2025
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 FELICITY ST
NEW ORLEANS LA
70130-4669
US

IV. Provider business mailing address

940 FELICITY ST
NEW ORLEANS LA
70130-4669
US

V. Phone/Fax

Practice location:
  • Phone: 346-453-0374
  • Fax:
Mailing address:
  • Phone: 346-453-0374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL OLUSANYA
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 929-678-7901