Provider Type Icon

NORTHSIDE BEHAVIORAL HEALTH CENTER INC. NPI 1669498002


NPI Information

NPI: 1669498002
Provider Name: NORTHSIDE BEHAVIORAL HEALTH CENTER, INC.

Former Legal Business Name: NORTHSIDE MENTAL HEALTH CTR, INC

Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
12512 BRUCE B DOWNS BLVD
TAMPA, FL
ZIP 33612
Phone: (813) 977-8700
Get Directions

NORTHSIDE BEHAVIORAL HEALTH CENTER, INC. is a mental health (including community mental health center) clinic center in Tampa, FL. NORTHSIDE BEHAVIORAL HEALTH CENTER, INC. NPI is 1669498002. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Northside Mental Health Ctr, Inc.

The provider's business location address is:

12512 BRUCE B DOWNS BLVD
TAMPA, FL
ZIP 33612
Phone: (813) 977-8700
Fax: (813) 971-2029

The provider's authorized official is Lynda Gorken .
The authorized official title is Vice President and has the following contact phone number (727) 281-9202.

The enumeration date for this NPI number is 7/15/2006 and was last updated on 8/1/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1117042300MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.