| Real Psychiatric Services Llc | |
|
4770 Indianola Ave Ste 111 Columbus OH 43214-1862 | |
| (614) 427-3205 | |
| (866) 376-9053 |
| Full Name | Real Psychiatric Services Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4770 Indianola Ave Ste 111, Columbus, Ohio |
| Authorized Official Name and Position | David Peter Glenn (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 6144273205 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Real Psychiatric Services Llc 4770 Indianola Ave Ste 111 Columbus OH 43214-1862 Ph: (614) 427-3205 | Real Psychiatric Services Llc 4770 Indianola Ave Ste 111 Columbus OH 43214-1862 Ph: (614) 427-3205 |
| NPI Number | 1861102105 |
|---|---|
| Provider Enumeration Date | 11/28/2022 |
| Last Update Date | 06/30/2023 |
| Certification Date | 06/30/2023 |
| Medicare PECOS PAC ID | 0749700631 |
|---|---|
| Medicare Enrollment ID | O20250221002583 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861102105 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | David Peter Glenn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316491673 PECOS PAC ID: 1658891544 Enrollment ID: I20250318001700 |
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