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General NPI Number Information
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NPI Number | 1033911722
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Entity Type | Organization
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Legal Business Name | ATYPICAL PSYCHIATRY LLC
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Dates
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Enumeration Date | 03/25/2025
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | 1583 N MAIN ST
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City | MARION
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State | VA
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Zip | 24354-4317
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Country | US
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Telephone | 276-247-9669
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Fax | 276-243-0057
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Provider Business Mailing Address
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Address Line | 1583 N MAIN ST
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City | MARION
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State | VA
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Zip | 24354-4317
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Country | US
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Telephone | 276-247-9669
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Fax | 276-243-0057
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Authorized Official
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Title or Position | OWNER
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Name | LAURA CARMICKLE
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Credential | APRN
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Telephone | 469-915-4211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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