PHS BEHAVIORAL MEDICINE – NPI #1396012837
Psychiatry & Neurology

A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine

PHS BEHAVIORAL MEDICINE is a psychiatry & neurologist located in WASHINGTON, DC. NPPES has assigned the NPI number 1396012837 to PHS BEHAVIORAL MEDICINE on November 29, 2011. It is a Type-2 NPI, indicating this NPI number is associated with an organization. PHS BEHAVIORAL MEDICINE is also known by the name PROVIDENCE HEALTH SERVICES. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 2084A0401X from the Health Care Provider Taxonomy code set, which is classified as Psychiatry & Neurology, specializing in Addiction Medicine

The NPI profile was previously updated about 10 years ago on Sep 06, 2016. 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 PHS BEHAVIORAL MEDICINE below.

NPI Profile for
PHS BEHAVIORAL MEDICINE

NPI Number
1396012837
Enumeration Date

(more than 14 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
PHS BEHAVIORAL MEDICINE
Other Name: PROVIDENCE HEALTH SERVICES
Primary location
1053 BUCHANAN ST NE
SUITE 055
WASHINGTON, DC 20017-2712
Phone: (202) 269-7626 Fax: (202) 269-7616
Mailing address
1150 VARNUM ST NE
ST CATHERINE'S HALL, ROOM 102
WASHINGTON, DC 20017-2104
Phone: (202) 854-4069 Fax: (202) 854-7825
Organization Subpart
Yes - PHS BEHAVIORAL MEDICINE is subpart of another organization.
Authorized Official
CHARLES HABERKERN
VP
Phone: (202) 854-4255
Updated
Identifiers

Identifiers for PHS BEHAVIORAL MEDICINE

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
MEDICAIDDC029833400
MEDICAIDMD005145400
MEDICAIDVA09810714
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
2084A0401X
- Psychiatry & Neurology / Addiction Medicine (Primary)
DC HFD01-0212
282N00000X
- General Acute Care Hospital
DC HFD01-0112
2084N0400X
- Psychiatry & Neurology / Neurology
DC HFD01-0212

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.