| Cassada Psychiatric Clinic Pc | |
|
304 S Deer Creek Dr W Leland MS 38756-3130 | |
| (662) 820-6899 | |
| Not Available |
| Full Name | Cassada Psychiatric Clinic Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 304 S Deer Creek Dr W, Leland, Mississippi |
| Authorized Official Name and Position | Margaret Kea Ogden Cassada (PRESIDENT CEO) |
| Authorized Official Contact | 6628206899 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cassada Psychiatric Clinic Pc Po Box 939 Leland MS 38756-0939 Ph: (662) 820-6899 | Cassada Psychiatric Clinic Pc 304 S Deer Creek Dr W Leland MS 38756-3130 Ph: (662) 820-6899 |
| NPI Number | 1538358288 |
|---|---|
| Provider Enumeration Date | 10/18/2007 |
| Last Update Date | 08/31/2010 |
| Medicare PECOS PAC ID | 6305739681 |
|---|---|
| Medicare Enrollment ID | O20040203000182 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538358288 | NPI | - | NPPES |
| 06907260 | Medicaid | MS | |
| 1427032754 | Other | MS | INDIVIDUAL NPI # |
| 227119428B | Other | MS | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 16112 (Mississippi) | Primary |
| Provider Name | Margaret K Cassada |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427032754 PECOS PAC ID: 3476446758 Enrollment ID: I20040209000494 |
Indianola Clinic, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 Baker Blvd, Leland, MS 38756 Phone: 662-686-4121 Fax: 662-686-4770 |