| Couch Psychiatry, Pc | |
|
6330 W Flamingo Rd Unit 106 Las Vegas NV 89103-2234 | |
| (702) 280-6805 | |
| (415) 696-1090 |
| Full Name | Couch Psychiatry, Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 6330 W Flamingo Rd Unit 106, Las Vegas, Nevada |
| Authorized Official Name and Position | Joseph Naylor Kenan (OWNER) |
| Authorized Official Contact | 7022706805 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Couch Psychiatry, Pc 901 Fremont St Apt 374 Las Vegas NV 89101-5439 Ph: (792) 280-6805 | Couch Psychiatry, Pc 6330 W Flamingo Rd Unit 106 Las Vegas NV 89103-2234 Ph: (702) 280-6805 |
| NPI Number | 1053161257 |
|---|---|
| Provider Enumeration Date | 03/22/2024 |
| Last Update Date | 05/09/2024 |
| Certification Date | 05/09/2024 |
| Medicare PECOS PAC ID | 0446793574 |
|---|---|
| Medicare Enrollment ID | O20240618001708 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053161257 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | (* (Not Available)) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Joseph Kenan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225302755 PECOS PAC ID: 0345499281 Enrollment ID: I20240618001859 |
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