Provider Demographics
NPI:1730875022
Name:PSYCH SOLUTIONS LLC
Entity type:Organization
Organization Name:PSYCH SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, CNP, PMHNP-BC
Authorized Official - Phone:218-428-8420
Mailing Address - Street 1:4833 MORRIS THOMAS RD
Mailing Address - Street 2:
Mailing Address - City:HERMANTOWN
Mailing Address - State:MN
Mailing Address - Zip Code:55811-3708
Mailing Address - Country:US
Mailing Address - Phone:218-428-8420
Mailing Address - Fax:
Practice Address - Street 1:4833 MORRIS THOMAS RD
Practice Address - Street 2:
Practice Address - City:HERMANTOWN
Practice Address - State:MN
Practice Address - Zip Code:55811-3708
Practice Address - Country:US
Practice Address - Phone:218-428-8420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty