Provider Demographics
NPI:1033872866
Name:ADVANCED PSYCH CARE PLLC
Entity type:Organization
Organization Name:ADVANCED PSYCH CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:NORRINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCNELLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-975-2132
Mailing Address - Street 1:300 BRICKSTONE SQ STE 201
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-1497
Mailing Address - Country:US
Mailing Address - Phone:603-892-9922
Mailing Address - Fax:603-458-1329
Practice Address - Street 1:300 BRICKSTONE SQ STE 201
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-1497
Practice Address - Country:US
Practice Address - Phone:603-892-9922
Practice Address - Fax:603-458-1329
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVANCED PSYCH CARE PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1861970972OtherMENTAL HELATH/PSYCHIATRY