An individual licensed by the state board as a Psychiatric Technician based upon completion of a prescribed course of theory and clinical practice, with two thirds of the clinical practice time focused on mental and developmental disorders. The psychiatric technician practices under the direct supervision of a physician, psychologist, registered nurse or other professional to provide care to patients with mental disorders and developmental disabilities.
| Specialty | Taxonomy Code | |
|---|---|---|
| * | Licensed Psychiatric Technician | 167G00000X |
| Foster Care Agency | 253J00000X |
* Indicates primary specialty
| NPI Number | 1245043736 |
| Legal business name LBN |
BROOKSIDE ACADEMY BUSINESS |
| Authorized official | JONATHAN COMER - (OWNER) |
| Entity | Organization |
| Organization subpart | Yes |
| Enumeration date | 01/29/2025 |
| Last updated | 01/29/2025 - More than a year ago |
| Sole proprietor1 | Not specified |
| Identifiers | n/a |
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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