Psychiatric Nurse Practitioner Services Llc

LBN: Telemental Health Link Llc
Psychiatric Nurse Practitioner Services Llc is an health care organization with primary practice located at 4055 E Blueberry St , Meridian ID 83642-8261. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Multi-Specialty, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is the primary health care specialty. Telemental Health Link Llc can be contacted via phone (208) 775-7418, or through Derivas, Susan M via phone (208) 775-7418.

Contact Information

Primary practice address
4055 E Blueberry St Meridian ID 83642-8261
Phone: (208) 775-7418
Fax: (208) 647-5008
Website:
Map and Directions
Authorized official contact:
Name: Derivas, Susan M PMHNP-BC
Phone: (208) 775-7418

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Multi-Specialty 261QM1300X
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X

Profile Details

NPI number 1437783529
LBN Legal business name Telemental Health Link Llc
DBA Doing business as Psychiatric Nurse Practitioner Services Llc
Authorized official Derivas, Susan M PMHNP-BC
Entity Organization
Organization subpart 1 Yes
Enumeration date Feb 27th, 2020
Last updated Feb 7th, 2024 - about 10 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437783529 NPPES
Other 396453OSMIND CHANGE HEALTHCARE MASTER BILLING ID
Other 58322 CHANGE HEALTHCARE MASTER BILLING ID
Other 58322 CHANGE HEALTHCARE MASTER BILLING ID
MEDICAID 020837 CHANGE HEALTHCARE MASTER BILLING ID
Other 13961493 CHANGE HEALTHCARE MASTER BILLING ID
Other 64266 CHANGE HEALTHCARE MASTER BILLING ID
Other 03962 CHANGE HEALTHCARE MASTER BILLING ID
Other 1529234 CHANGE HEALTHCARE MASTER BILLING ID
Other 0364158 CHANGE HEALTHCARE MASTER BILLING ID
Other 363LP0808X CHANGE HEALTHCARE MASTER BILLING ID
Other P69441 CHANGE HEALTHCARE MASTER BILLING ID

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