| Psychiatric Associates Inc | |
| 
					6406 N Santa Fe Ave Ste A Oklahoma City OK 73116-9117  | |
| (405) 840-3793 | |
| (405) 840-3794 | 
| Full Name | Psychiatric Associates Inc | 
|---|---|
| Speciality | Psychiatry & Neurology | 
| Location | 6406 N Santa Fe Ave Ste A, Oklahoma City, Oklahoma | 
| Authorized Official Name and Position | Fay Mitchell (OFFICE MANAGER) | 
| Authorized Official Contact | 4058403793 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Psychiatric Associates Inc 6406 N Santa Fe Ave Ste A Oklahoma City OK 73116-9117 Ph: (405) 840-3793  | Psychiatric Associates Inc 6406 N Santa Fe Ave Ste A Oklahoma City OK 73116-9117 Ph: (405) 840-3793  | 
| NPI Number | 1205893674 | 
|---|---|
| Provider Enumeration Date | 04/28/2006 | 
| Last Update Date | 07/15/2022 | 
| Certification Date | 07/15/2022 | 
| Medicare PECOS PAC ID | 2264334671 | 
|---|---|
| Medicare Enrollment ID | O20040126000426 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1205893674 | NPI | - | NPPES | 
| 100740060A | Medicaid | OK | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary | 
| Provider Name | Maryellen L Dodd | 
|---|---|
| Provider Type | Practitioner - Psychiatry | 
| Provider Identifiers | NPI Number: 1831176916 PECOS PAC ID: 3476532326 Enrollment ID: I20060615000031  | 
| Provider Name | Karen K Ross | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1790753952 PECOS PAC ID: 1052573896 Enrollment ID: I20120424000505  | 
| Provider Name | John Rahhal | 
|---|---|
| Provider Type | Practitioner - Psychiatry | 
| Provider Identifiers | NPI Number: 1164490223 PECOS PAC ID: 2365468188 Enrollment ID: I20150123000425  | 
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