Provider Demographics
NPI:1174709638
Name:FAMILY MENTAL HEALTH II, P.C.
Entity type:Organization
Organization Name:FAMILY MENTAL HEALTH II, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:BHUYAN, M.D.
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-872-7069
Mailing Address - Street 1:443 N NEW BALLAS RD
Mailing Address - Street 2:SUITE NUMBER 249
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6800
Mailing Address - Country:US
Mailing Address - Phone:314-872-7069
Mailing Address - Fax:314-872-9103
Practice Address - Street 1:443 N NEW BALLAS RD
Practice Address - Street 2:SUITE NUMBER 249
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6800
Practice Address - Country:US
Practice Address - Phone:314-872-7069
Practice Address - Fax:314-872-9103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-15
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR8153103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty