Provenance Psychiatric Services LLC
Provenance Psychiatric Services LLC is a Psychiatric/Mental Health Clinical Nurse Specialist in Blairsville, Georgia. Registered with an NPI since 2023.
- In the registry since
- 2023
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
643 Ray Lewis RdBlairsville, GA 30512-1439
Phone: (706) 970-1948
Fax: (877) 930-7732
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Psychiatric/Mental Health Clinical Nurse Specialist (primary) | Taxonomy 364SP0808X |
|---|
Record details
| NPI number | 1932885530 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Brian Johnson — Owner · (610) 453-1548 |
| Other names | Provenance Psychiatry |
| NPI enumerated | June 27, 2023 |
| Last updated in NPPES | March 19, 2025 |
| Certification date | March 19, 2025 |
| Mailing address | 643 Ray Lewis Rd, Blairsville, GA 30512-1439 |