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General NPI Number Information
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NPI Number | 1639828742
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Entity Type | Organization
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Legal Business Name | PSYCHCARE ANYWHERE LLC
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Dates
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Enumeration Date | 03/23/2022
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Last Update Date | 11/30/2022
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Provider Practice Location Address
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Address Line | 200 E CAMPUS VIEW BLVD STE 200
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City | COLUMBUS
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State | OH
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Zip | 43235-4678
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Country | US
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Telephone | 888-589-8808
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Fax |
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Provider Business Mailing Address
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Address Line | 7385 STATE ROUTE 3 # 1050
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City | WESTERVILLE
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State | OH
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Zip | 43082-8654
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Country | US
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Telephone | 888-589-8808
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Fax | 928-268-0236
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Authorized Official
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Title or Position | CEO
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Name | STACEY MOLLE
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Credential | CNP
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Telephone | 614-715-3021
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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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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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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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Taxonomy #4
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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