Provider Demographics
NPI:1427757400
Name:SWEET FELICITY CLINIC OF PSYCHIATRY
Entity type:Organization
Organization Name:SWEET FELICITY CLINIC OF PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNP
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:CARYN
Authorized Official - Last Name:AUSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:513-560-1023
Mailing Address - Street 1:PO BOX 502
Mailing Address - Street 2:
Mailing Address - City:FELICITY
Mailing Address - State:OH
Mailing Address - Zip Code:45120-0502
Mailing Address - Country:US
Mailing Address - Phone:513-560-1023
Mailing Address - Fax:513-672-0844
Practice Address - Street 1:311 W WALNUT LANE
Practice Address - Street 2:502
Practice Address - City:FELICITY
Practice Address - State:OH
Practice Address - Zip Code:45120-0502
Practice Address - Country:US
Practice Address - Phone:513-560-1023
Practice Address - Fax:513-672-0844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health