| Psychnow | |
|
4656 W Jefferson Blvd Ste 285 Fort Wayne IN 46804-6838 | |
| (260) 422-9372 | |
| Not Available |
| Full Name | Psychnow |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4656 W Jefferson Blvd Ste 285, Fort Wayne, Indiana |
| Authorized Official Name and Position | Kimra K Reed (OWNER) |
| Authorized Official Contact | 2606103057 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychnow 4656 W Jefferson Blvd Ste 285 Fort Wayne IN 46804-6838 Ph: (260) 422-9372 | Psychnow 4656 W Jefferson Blvd Ste 285 Fort Wayne IN 46804-6838 Ph: (260) 422-9372 |
| NPI Number | 1053943779 |
|---|---|
| Provider Enumeration Date | 02/11/2020 |
| Last Update Date | 05/27/2020 |
| Certification Date | 05/27/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053943779 | NPI | - | NPPES |
| 201296650 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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