BEHAVIORAL HEALTH PROFESSIONALS – NPI #1063810091
Family Medicine

A family medicine physician who specializes in the diagnosis and treatment of addictions.

BEHAVIORAL HEALTH PROFESSIONALS is a provider located in PIKEVILLE, KY. NPPES has assigned the NPI number 1063810091 to BEHAVIORAL HEALTH PROFESSIONALS on December 08, 2014. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “BEHAVIORAL HEALTH PROFESSIONALS” is a dba name, the actual legal business name for this organization is RENEW ADDICTION TREATMENT CENTER. This provider is also associated with 2 additional names listed below. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207QA0401X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine, specializing in Addiction Medicine

The NPI profile was previously updated about 4 years ago on Sep 09, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BEHAVIORAL HEALTH PROFESSIONALS below.

NPI Profile for
RENEW ADDICTION TREATMENT CENTER

NPI Number
1063810091
Enumeration Date

(more than 11 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
RENEW ADDICTION TREATMENT CENTER
Doing Business As (dba): BEHAVIORAL HEALTH PROFESSIONALS
Other name(s)
All associated names:
Doing Business As (dba)
BEHAVIORAL HEALTH PROFESSIONALS
Doing Business As (dba)
Renew ATC
Primary location
400 VENTERS LN STE 100
PIKEVILLE, KY 41501-3016
Phone: (606) 653-1505 Fax:
Mailing address
PO BOX 1285
PIKEVILLE, KY 41502-1285
Phone: Fax:
Organization Subpart
Yes - BEHAVIORAL HEALTH PROFESSIONALS is subpart of another organization.
Authorized Official
AMBER SISCO
MANAGING MEMBER
Phone: (606) 653-1505
Updated
Certification Date
Sep 09, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for BEHAVIORAL HEALTH PROFESSIONALS

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERSTATE FACILITY LICENSE- SPECIAL HEALTH CLINICKY740318
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207QA0401X
- Family Medicine / Addiction Medicine (Primary)
KY 740318
2084A0401X
- Psychiatry & Neurology / Addiction Medicine
KY 740318
207RA0401X
- Internal Medicine / Addiction Medicine
KY 740318

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.