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General NPI Number Information
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NPI Number | 1447485958
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Entity Type | Organization
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Legal Business Name | ERNST PSYCHIATRIC SERVICES, LLC
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Dates
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Enumeration Date | 05/28/2009
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Last Update Date | 02/25/2010
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Provider Practice Location Address
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Address Line | 100 5TH ST STE 340 SHELBY SQUARE
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City | BRISTOL
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State | TN
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Zip | 37620-5919
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Country | US
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Telephone | 423-990-2100
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Fax | 423-652-2884
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Provider Business Mailing Address
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Address Line | P.O. BOX 154
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City | BRISTOL
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State | TN
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Zip | 37621-0154
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Country | US
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Telephone | 423-990-2100
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Fax | 423-652-2884
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Authorized Official
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Title or Position | OWNER
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Name | MS. MARY PAT ERNST
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Credential | APRN, BC
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Telephone | 423-990-2100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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