Provider Demographics
NPI:1891512000
Name:ORIGIN PSYCHIATRY & COUNSELING, LLC
Entity type:Organization
Organization Name:ORIGIN PSYCHIATRY & COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PSYCH NP
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DELANEY
Authorized Official - Suffix:
Authorized Official - Credentials:DNP PMHNP-BC
Authorized Official - Phone:813-738-4024
Mailing Address - Street 1:802 TURKEY CRK
Mailing Address - Street 2:
Mailing Address - City:ALACHUA
Mailing Address - State:FL
Mailing Address - Zip Code:32615-9313
Mailing Address - Country:US
Mailing Address - Phone:813-738-4024
Mailing Address - Fax:352-329-4372
Practice Address - Street 1:14520 MAIN ST # 40
Practice Address - Street 2:
Practice Address - City:ALACHUA
Practice Address - State:FL
Practice Address - Zip Code:32615-8592
Practice Address - Country:US
Practice Address - Phone:813-738-4024
Practice Address - Fax:352-329-4372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-20
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health