Provider Demographics
NPI:1447444864
Name:PSYCARE INC
Entity type:Organization
Organization Name:PSYCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TRISH
Authorized Official - Middle Name:A
Authorized Official - Last Name:RENO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-657-1881
Mailing Address - Street 1:26 NESBITT RD
Mailing Address - Street 2:STE 110
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-3410
Mailing Address - Country:US
Mailing Address - Phone:724-657-1881
Mailing Address - Fax:724-657-9178
Practice Address - Street 1:26 NESBITT RD
Practice Address - Street 2:STE 110
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-3410
Practice Address - Country:US
Practice Address - Phone:724-657-1881
Practice Address - Fax:724-657-9178
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PSYCARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0142761041C0700X
PACW0149701041C0700X
PACW0122081041C0700X
PAMD045410E2084P0800X
PARN285726L364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA090877Medicare PIN
PAS39000Medicare UPIN
PAQ43437Medicare UPIN
PAF81209Medicare UPIN
PA903565Medicare PIN
PA899504Medicare PIN
PA878742Medicare PIN
PA726714Medicare PIN
PAS64391Medicare UPIN