PHS OUTPATIENT BEHAVIORAL HEALTH – NPI #1609031632
Psychiatry & Neurology

A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

PHS OUTPATIENT BEHAVIORAL HEALTH is a psychiatry & neurologist located in WASHINGTON, DC. NPPES has assigned the NPI number 1609031632 to PHS OUTPATIENT BEHAVIORAL HEALTH on July 18, 2008. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “PHS OUTPATIENT BEHAVIORAL HEALTH” is a dba name, the actual legal business name for this organization is PROVIDENCE HEALTH SERVICES, INC. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 2084N0400X from the Health Care Provider Taxonomy code set, which is classified as Psychiatry & Neurology, specializing in Neurology Please note, simply having a taxonomy code selected doesn't replace any credentialing or validation process that may be required by law.

The NPI profile was previously updated about 3 years ago on Oct 20, 2023. 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 OUTPATIENT BEHAVIORAL HEALTH below.

NPI Profile for
PROVIDENCE HEALTH SERVICES, INC

NPI Number
1609031632
Enumeration Date

(about 18 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
PROVIDENCE HEALTH SERVICES, INC
Doing Business As (dba): PHS OUTPATIENT BEHAVIORAL HEALTH
Primary location
1140 VARNUM ST NE STE 100
WASHINGTON, DC 20017
Phone: (202) 854-7623 Fax: (202) 854-7616
Mailing address
1150 VARNUM ST NE
ST CATHERINES HALL 102
WASHINGTON, DC 20017-2180
Phone: (202) 854-4069 Fax: (202) 269-7825
Organization Subpart
Yes - PHS OUTPATIENT BEHAVIORAL HEALTH is subpart of another organization.
Authorized Official
MITCHELL LOMAX
VICE PRESIDENT/CFO
Phone: (667) 234-2926
Updated
Certification Date
Oct 20, 2023

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 PHS OUTPATIENT BEHAVIORAL HEALTH

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
medicaidMD985415100
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
2084N0400X
- Psychiatry & Neurology / Neurology (Primary)
DC HFD01-0212
2084B0040X
- Psychiatry & Neurology / Behavioral Neurology & Neuropsychiatry
DC HFD01-0212
2084A0401X
- Psychiatry & Neurology / Addiction Medicine
DC HFD01-0212
104100000X
- Social Worker
DC HFD01-0212
103T00000X
- Psychologist
DC HFD01-0212
101Y00000X
- Counselor
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.