Provider Demographics
NPI:1538748470
Name:MYK PSYCHIATRY LLC
Entity type:Organization
Organization Name:MYK PSYCHIATRY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PMHNP/FNP
Authorized Official - Prefix:MS
Authorized Official - First Name:MANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:RHONE
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:443-820-5796
Mailing Address - Street 1:188 THOMAS JOHNSON DR STE 202
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-5122
Mailing Address - Country:US
Mailing Address - Phone:301-378-0178
Mailing Address - Fax:443-458-4503
Practice Address - Street 1:188 THOMAS JOHNSON DR STE 202
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-5122
Practice Address - Country:US
Practice Address - Phone:301-378-0178
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-07
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty