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General NPI Number Information
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NPI Number | 1164238069
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Entity Type | Organization
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Legal Business Name | PSYCHED LLC
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Dates
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Enumeration Date | 12/05/2024
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 5202 BETHEL REED PARK SUITE 100
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City | COLUMBUS
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State | OH
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Zip | 43220
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Country | US
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Telephone | 614-859-5010
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Fax | 614-587-8882
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Provider Business Mailing Address
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Address Line | 1391 W 5TH AVE STE 307
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City | COLUMBUS
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State | OH
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Zip | 43212-2902
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Country | US
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Telephone | 614-859-5010
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Fax | 614-587-8882
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Authorized Official
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Title or Position | CEO / PRESIDENT
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Name | SUMMER LAWSON
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Credential | APRN-CNP, PMHNP
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Telephone | 614-859-5010
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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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