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NPI Code Detail

MEDICARE: ERNST PSYCHIATRIC SERVICES, LLC

MEDICARE: ERNST PSYCHIATRIC SERVICES, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1447485958
Entity Type Code : Organization
Provider Name (Legal Business Name) : ERNST PSYCHIATRIC SERVICES, LLC
Provider Business Mailing Address
First Line : P.O. BOX 154
Second Line :
City : BRISTOL
State : TN
Zip : 37621-0154
Country : US
Telephone Number : 423-990-2100
Fax Number : 423-652-2884
Provider Business Practice Location Address
First Line : 100 5TH ST STE 340
Second Line : SHELBY SQUARE
City : BRISTOL
State : TN
Zip : 37620-5919
Country : US
Telephone Number : 423-990-2100
Fax Number : 423-652-2884
Authorized Official
Title or Position : OWNER
Name : MS. MARY PAT ERNST
Credential : APRN, BC
Telephone Number : 423-990-2100
Provider Enumeration Date : 05/28/2009
Last Update Date : 02/25/2010

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Directions to “ERNST PSYCHIATRIC SERVICES, LLC ” Practice Location

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