| Ivymed Behavioral Health Pllc | |
|
700 Central Expy S Ste 400 Allen TX 75013-8113 | |
| (844) 688-4866 | |
| (844) 688-4878 |
| Full Name | Ivymed Behavioral Health Pllc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 700 Central Expy S Ste 400, Allen, Texas |
| Authorized Official Name and Position | Ivy Jones (SOLE MEMBER) |
| Authorized Official Contact | 8446884866 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ivymed Behavioral Health Pllc 700 Central Expy S Ste 400 Allen TX 75013-8113 Ph: (844) 688-4866 | Ivymed Behavioral Health Pllc 700 Central Expy S Ste 400 Allen TX 75013-8113 Ph: (844) 688-4866 |
| NPI Number | 1407556004 |
|---|---|
| Provider Enumeration Date | 03/03/2023 |
| Last Update Date | 02/13/2024 |
| Certification Date | 02/13/2024 |
| Medicare PECOS PAC ID | 5890150486 |
|---|---|
| Medicare Enrollment ID | O20230504000971 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407556004 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
| Provider Name | Ivy Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578145504 PECOS PAC ID: 8820337306 Enrollment ID: I20230504001106 |
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