Provider Demographics
NPI:1992781074
Name:PSYCHIATRIC SERVICES, PC
Entity type:Organization
Organization Name:PSYCHIATRIC SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:JONES
Authorized Official - Suffix:IV
Authorized Official - Credentials:MD
Authorized Official - Phone:402-399-9305
Mailing Address - Street 1:9239 W CENTER RD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-1900
Mailing Address - Country:US
Mailing Address - Phone:402-399-9305
Mailing Address - Fax:402-397-3191
Practice Address - Street 1:9239 W CENTER RD
Practice Address - Street 2:SUITE 211
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-1900
Practice Address - Country:US
Practice Address - Phone:402-399-9305
Practice Address - Fax:402-397-3191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-20
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE100212000OtherMAGELLAN
NE=========00Medicaid
NE100212000OtherMAGELLAN