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Contact Information

PARK PLACE PSYCHIATRY, LLC
207 WINTON M. BLOUNT LOOP
MONTGOMERY, AL36117
 Phone: 334-356-1417
 Fax: 334-356-1433
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Mental Health

101YM0800X
 

Professional

101YP2500X
Indicates primary specialty

NPI Profile & details for PARK PLACE PSYCHIATRY LLC · (Female)

NPI Number 1629108261
Status Active
Credentials
Entity Individual
Enumeration date 03/06/2007
Last updated 06/14/2013 - About 13 years ago
Sole proprietor 1 Not specified
Identifiers
  • AL License # 1452
  • AL License # 2914
  • AL License # D0421
  • AL Medicaid 529906980
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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