Organization
SPRINGFIELD PSYCHIATRIC ASSOCIATES INC
Active
Other names
Springfield Psychiatric Associates
Organization subpart
No
Provider details
NPI number
Authorized official
PRAMILA VELLANKI (OFFICE MANAGER)
(937) 342-9030
Entity
Organization
Contact information
Practice address
3162 EL CAMINO DR, SPRINGFIELD, OH 45503-1318
(937) 342-9030
(937) 342-9039
Mailing address
3162 EL CAMINO DR, SPRINGFIELD, OH 45503-1318
(937) 342-9030
(937) 342-9039
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
I.0002982
OH
1041C0700X
Clinical Social Worker
I.0002982
OH
2084P0800X
Psychiatry Physician
Primary
35063060
OH
2084P0804X
Child & Adolescent Psychiatry Physician
35063060
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9341501
MEDICARE
OH
Enumeration date
02/05/2007
Last updated
07/22/2024
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