Provider Demographics
NPI:1124692165
Name:MYK PSYCHIATRY LLC
Entity type:Organization
Organization Name:MYK PSYCHIATRY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MSN, CRNP
Authorized Official - Prefix:
Authorized Official - First Name:MANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:RHONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-398-2360
Mailing Address - Street 1:188 THOMAS JOHNSON DR STE 202
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-5122
Mailing Address - Country:US
Mailing Address - Phone:301-378-0178
Mailing Address - Fax:443-281-6379
Practice Address - Street 1:188 THOMAS JOHNSON DR STE 202
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-5122
Practice Address - Country:US
Practice Address - Phone:301-378-0178
Practice Address - Fax:443-281-6379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-14
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Single Specialty