Provider Demographics
NPI:1194574921
Name:RESILIENT PSYCHIATRY LLC
Entity type:Organization
Organization Name:RESILIENT PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:SENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:PAUL PASCAL
Authorized Official - Suffix:
Authorized Official - Credentials:RN, APRN
Authorized Official - Phone:386-585-5828
Mailing Address - Street 1:100 E NEW YORK AVE STE 103SS
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32724-5575
Mailing Address - Country:US
Mailing Address - Phone:386-585-5828
Mailing Address - Fax:
Practice Address - Street 1:100 E NEW YORK AVE STE 103SS
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32724-5575
Practice Address - Country:US
Practice Address - Phone:386-585-5828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty