| Psych Alchemy LLC | |
|
310 N High Street Extended Smyrna DE 19977-1183 | |
| (302) 275-5717 | |
| Not Available |
| Full Name | Psych Alchemy LLC |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 310 N High Street Extended, Smyrna, Delaware |
| Authorized Official Name and Position | Roni Becker (VICE PRESIDENT/TREASURER) |
| Authorized Official Contact | 3022716868 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psych Alchemy LLC 310 N High Street Extended Smyrna DE 19977-1183 Ph: (302) 275-5717 | Psych Alchemy LLC 310 N High Street Extended Smyrna DE 19977-1183 Ph: (302) 275-5717 |
| NPI Number | 1588494819 |
|---|---|
| Provider Enumeration Date | 08/02/2024 |
| Last Update Date | 08/19/2024 |
| Certification Date | 08/19/2024 |
| Medicare PECOS PAC ID | 1759814908 |
|---|---|
| Medicare Enrollment ID | O20241028001323 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588494819 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (NU) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (NU) | Primary |
| Provider Name | Laura B Hummel |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1457437774 PECOS PAC ID: 0143316794 Enrollment ID: I20190730000045 |
| Provider Name | Catherine M Luko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578236303 PECOS PAC ID: 1850797143 Enrollment ID: I20210913001173 |
| Provider Name | Roni Becker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588437503 PECOS PAC ID: 8527591692 Enrollment ID: I20241028002438 |
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