NPIMap

Organization Active NPI

Therapeutic Medical & Psychiatric Services LLC.

  • Psychiatric/Mental Health Nurse Practitioner
  • Monroe, LA
National Provider Identifier
1750672390
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
THERAPEUTIC MEDICAL & PSYCHIATRIC SERVICES LLC.
Practice address
1501 Stubbs Ave
Monroe, LA 71292-1106
Phone
(318) 396-9712
Fax
(180) 051-8423
NPI assigned
May 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Authorized official

Name
Mrs. Diane Privitor Privitor Davis, APRN, FNP-C, PMHNPBC
Title
Owner
Phone
(318) 816-5116

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X APO5002 LA
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

1501 Stubbs Ave
Monroe, LA 71292-1106

Mailing address

200 Winterpark Dr
West Monroe, LA 71292-1106
Phone (318) 396-9712

Other identifiers 1

IdentifierTypeStateIssuer
0000000000000OtherLAPRIVATE INSURANCE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dianenp@medical-psych.net Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110516000231 LA Part B Supplier - Clinic/Group Practice 8022294776 Receives reassigned benefits from 3 practitioners
Practice locations: Monroe, LA

National Provider Directory

National Provider Directory

Locations

1707 Royal Ave
Monroe, LA 71201
Phone (318) 816-5116

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1304208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1750672390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 WINTERPARK DR",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712921106",
            "telephone_number": "318-396-9712",
            "fax_number": "180-051-8423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 STUBBS AVE",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712921106",
            "telephone_number": "318-396-9712",
            "fax_number": "180-051-8423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPEUTIC MEDICAL & PSYCHIATRIC SERVICES LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-01",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "PRIVITOR DAVIS",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "PRIVITOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-816-5116",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN, FNP-C, PMHNPBC"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "APO5002",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE INSURANCE",
            "identifier": "0000000000000",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dianenp@medical-psych.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1501 Stubbs Ave",
            "city": "Monroe",
            "state": "LA",
            "country_code": "US",
            "postal_code": "712921106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.