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NPI Code Detail

MEDICARE: DR. KAYCIA L VANSICKLE MD

MEDICARE: DR. KAYCIA L VANSICKLE MD
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
12084P0800XPsychiatry Physician39199TN
22084P0800XPsychiatry PhysicianJ4584TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3557993000OTHERMAGELLAN
451529598OTHERALBCBS
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1780796755
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KAYCIA L VANSICKLE MD
Provider Business Mailing Address
First Line : 109 W 27TH ST STE 5S
Second Line :
City : NEW YORK
State : NY
Zip : 10001-6208
Country : US
Telephone Number : 917-634-5311
Fax Number :
Provider Business Practice Location Address
First Line : 1400 N COIT RD STE 302
Second Line :
City : MCKINNEY
State : TX
Zip : 75071-6656
Country : US
Telephone Number : 865-970-9800
Fax Number : 865-373-8225
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 07/19/2022

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Directions to “ DR. KAYCIA L VANSICKLE MD” Practice Location

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