Healthcare Provider Details

I. General information

NPI: 1447444864
Provider Name (Legal Business Name): PSYCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2007
Last Update Date: 08/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 NESBITT RD STE 110
NEW CASTLE PA
16105-3410
US

IV. Provider business mailing address

26 NESBITT RD STE 110
NEW CASTLE PA
16105-3410
US

V. Phone/Fax

Practice location:
  • Phone: 724-657-1881
  • Fax: 724-657-9178
Mailing address:
  • Phone: 724-657-1881
  • Fax: 724-657-9178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License NumberRN285726L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW014276
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW014970
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW012208
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD045410E
License Number StatePA

VIII. Authorized Official

Name: TRISH A RENO
Title or Position: MANAGER
Credential:
Phone: 724-657-1881