SOUTHERN PSYCHIATRY LLC
NPI 1467917898
Nurse Practitioner - Psychiatric/Mental Health in Crestview, FL

Q: What is Southern Psychiatry LLC's NPI number?

The NPI number for Southern Psychiatry LLC is 1467917898. It was assigned to this organization in the NPPES registry on February 11, 2019.

Q: What is Southern Psychiatry LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Active since February 11, 2019

500 HOSPITAL DR, CRESTVIEW, FL 32539(850) 687-0887 Get Directions Write a Review

NPPES record last updated: December 15, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 15, 2022, Dec 9, 2020, Feb 11, 2019 (3 updates tracked since 2019).

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About Southern Psychiatry Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHERN PSYCHIATRY LLC (NPI 1467917898) is a healthcare organization registered as a psychiatric/mental health in Crestview, Florida and active in the NPI registry since February 2019. The organization lists Renee Mccormack, Owner, as its authorized official.

NPPES Registry Identity

NPI1467917898

Entity TypeOrganization

Primary Taxonomy363LP0808X

Legal Business NameSOUTHERN PSYCHIATRY LLC

Location Address500 HOSPITAL DRCrestview, FL 32539-7355

Mailing Address201 N Blue Heron DrSanta Rosa Beach, FL 32459-3039 · (850) 687-0887

Phone(850) 687-0887

Organization SubpartNo

Authorized OfficialRenee MccormackOwner · (850) 687-0887

Enumeration DateFebruary 11, 2019

Last NPPES UpdateDecember 15, 20223 updates tracked since enumeration

NPPES CertifiedDecember 15, 2022

✔ NPI 1467917898 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X

Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X

500 HOSPITAL DR, Crestview, FL 32539

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Group Practice 2

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNY R GONZALES COTA

Occupational Therapy Assistant