Provider Demographics
NPI:1023338605
Name:PSYCARE INC
Entity type:Organization
Organization Name:PSYCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHD
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:DARNALL
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:330-270-1400
Mailing Address - Street 1:107 JAVIT CT STE B
Mailing Address - Street 2:
Mailing Address - City:AUSTINTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-2442
Mailing Address - Country:US
Mailing Address - Phone:330-270-1400
Mailing Address - Fax:330-270-1404
Practice Address - Street 1:107 JAVIT CT STE B
Practice Address - Street 2:
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-2442
Practice Address - Country:US
Practice Address - Phone:330-270-1400
Practice Address - Fax:330-270-1404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-07
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2460313Medicaid
OH9219957Medicare PIN