| Geropsych, A Division Of Key Rehabilitation, Inc | |
|
370 Old Shackle Island Rd Hendersonville TN 37075-3082 | |
| (615) 896-6400 | |
| Not Available |
| Full Name | Geropsych, A Division Of Key Rehabilitation, Inc |
|---|---|
| Speciality | Psychologist |
| Location | 370 Old Shackle Island Rd, Hendersonville, Tennessee |
| Authorized Official Name and Position | Janet S Irwin (CEO/PRESIDENT) |
| Authorized Official Contact | 6158966400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Geropsych, A Division Of Key Rehabilitation, Inc 1335 Nw Broad St Murfreesboro TN 37129-4428 Ph: (615) 896-6400 | Geropsych, A Division Of Key Rehabilitation, Inc 370 Old Shackle Island Rd Hendersonville TN 37075-3082 Ph: (615) 896-6400 |
| NPI Number | 1528136249 |
|---|---|
| Provider Enumeration Date | 12/01/2006 |
| Last Update Date | 03/10/2023 |
| Certification Date | 03/10/2023 |
| Medicare PECOS PAC ID | 9638086432 |
|---|---|
| Medicare Enrollment ID | O20040609001217 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528136249 | NPI | - | NPPES |
| 4097106 | Other | TN | BCBS |
| 4022354 | Other | TN | BCBS |
| Provider Name | Norman Nygard |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073562963 PECOS PAC ID: 2264326909 Enrollment ID: I20080618000674 |
| Provider Name | Tamra A Fagan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508967845 PECOS PAC ID: 1254510209 Enrollment ID: I20110124000865 |
| Provider Name | Lynn Petras |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1710059340 PECOS PAC ID: 6305096637 Enrollment ID: I20121023000568 |
| Provider Name | Paula Denise Fowler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962908699 PECOS PAC ID: 4486068517 Enrollment ID: I20210201000210 |
| Provider Name | Susan Mayo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619283447 PECOS PAC ID: 4688071749 Enrollment ID: I20210916002108 |
| Provider Name | Stacey Horn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578796017 PECOS PAC ID: 3072643311 Enrollment ID: I20230104002224 |
| Provider Name | Shaina Richardson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124767215 PECOS PAC ID: 3375902885 Enrollment ID: I20231113003506 |
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