| Northwest Alabama Psychiatric Services | |
|
20 Medical Center Dr Ste 300 Jasper AL 35501-3428 | |
| (205) 384-0141 | |
| (205) 384-0171 |
| Full Name | Northwest Alabama Psychiatric Services |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 20 Medical Center Dr Ste 300, Jasper, Alabama |
| Authorized Official Name and Position | Terry Wayne Bentley (PRESIDENT/OWNER) |
| Authorized Official Contact | 2053840141 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Alabama Psychiatric Services 20 Medical Center Dr Ste 300 Jasper AL 35501-3428 Ph: (205) 384-0141 | Northwest Alabama Psychiatric Services 20 Medical Center Dr Ste 300 Jasper AL 35501-3428 Ph: (205) 384-0141 |
| NPI Number | 1801962964 |
|---|---|
| Provider Enumeration Date | 11/28/2006 |
| Last Update Date | 10/26/2020 |
| Certification Date | 10/26/2020 |
| Medicare PECOS PAC ID | 7517986714 |
|---|---|
| Medicare Enrollment ID | O20051116001081 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801962964 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 16128 (Alabama) | Primary |
| Provider Name | Terry W Bentley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508933003 PECOS PAC ID: 1759452568 Enrollment ID: I20080623000483 |
| Provider Name | Edward Austin Tucker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619584505 PECOS PAC ID: 7618387457 Enrollment ID: I20201105000588 |
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