Psychiatric Services, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

CP000650 Issued in SD

Legal business name

PSYCHIATRIC SERVICES, LLC

Practice address

506 Lovely Ave
Baltic, SD 57003-0328

Phone

(605) 529-5240

Fax

(605) 610-1561

NPI assigned

Nov 19, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Brenda L Johnson, MS-CNPNPI 1710266473

Title

Owner

Phone

(605) 529-5240

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brenda Lenae Johnson, CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Brookings, SD
  • NPI 1710266473
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1321660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338336000000",
    "number": "1174890164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 LOVELY AVE",
            "address_2": "P.O. BOX 328",
            "city": "BALTIC",
            "state": "SD",
            "postal_code": "570030328",
            "telephone_number": "605-529-5240",
            "fax_number": "605-610-1561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 LOVELY AVE",
            "city": "BALTIC",
            "state": "SD",
            "postal_code": "570030328",
            "telephone_number": "605-529-5240",
            "fax_number": "605-610-1561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHIATRIC SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-19",
        "last_updated": "2012-05-30",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "605-529-5240",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS-CNP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "SD",
            "license": "CP000650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20110813516668",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Baltic School District
• Dylan Ryne Brende, DC
• Joy Pediatrics LLC
• Tammy Rae Lias, LMFT, QMHP
• Priority Surrogate Connection LLC
• Jennifer Ann Redmond, FNP-BC
• VA Hospital
• Kacie M. Wolf, PHARMD

• Mental Health Clinic/Center (Including Community Mental Health Center) in Baltic, SD
• Providers in Baltic, SD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.