1912618034 NPI number — SOUND PSYCHIATRY AND HEALTHCARE LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912618034 NPI number — SOUND PSYCHIATRY AND HEALTHCARE LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUND PSYCHIATRY AND HEALTHCARE LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912618034
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/31/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
310 S PACIFIC ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BUFFALO
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66717-2140
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
162-021-2383
Provider Business Mailing Address Fax Number:
620-679-1850

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
614 MERCHANT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EMPORIA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66801-2859
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
620-212-3832
Provider Business Practice Location Address Fax Number:
620-679-1850
Provider Enumeration Date:
12/09/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
YARNELL
Authorized Official First Name:
SCOT
Authorized Official Middle Name:
Authorized Official Title or Position:
APRN/BUSINESS OWNER
Authorized Official Telephone Number:
620-212-3832

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 201288510A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".