Provider Demographics
NPI:1063894202
Name:IAN L PRITCHARD LLC
Entity type:Organization
Organization Name:IAN L PRITCHARD LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER / MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:IAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:PRITCHARD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:775-200-0626
Mailing Address - Street 1:6170 RIDGEVIEW CT
Mailing Address - Street 2:SUITE C
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89519-6324
Mailing Address - Country:US
Mailing Address - Phone:775-200-0626
Mailing Address - Fax:775-825-8277
Practice Address - Street 1:1 E LIBERTY ST
Practice Address - Street 2:SUITE 600
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89501-2110
Practice Address - Country:US
Practice Address - Phone:775-525-0010
Practice Address - Fax:775-996-3287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-24
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPY0657251S00000X, 261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health