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SOUTH SUBURBAN MENTAL HEALTH GROUP NPI 1013963065


NPI Information

NPI: 1013963065
Provider Name: SOUTH SUBURBAN MENTAL HEALTH GROUP
Classification: Social Worker - 1041C0700X
Entity Type: Organization

Specialization: Clinical

Address:
180 E SPRING VALLEY RD
STE B
CENTERVILLE, OH
ZIP 45458
Phone: (937) 291-1351
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SOUTH SUBURBAN MENTAL HEALTH GROUP is a clinical social worker in Centerville, OH. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. SOUTH SUBURBAN MENTAL HEALTH GROUP NPI is 1013963065. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

180 E SPRING VALLEY RD
STE B
CENTERVILLE, OH
ZIP 45458-803
Phone: (937) 291-1351
Fax: (937) 291-1719

The provider's authorized official is Mark A Curtis .
The authorized official title is President and has the following contact phone number (937) 291-1351.

The enumeration date for this NPI number is 5/25/2006 and was last updated on 3/2/2009.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084P0800XPsychiatry & NeurologyPsychiatry35083573OHIONo
22084P0804XPsychiatry & NeurologyChild & Adolescent PsychiatryNo
3101YP2500XCounselorProfessionalNo
4364SP0808XClinical Nurse SpecialistPsychiatric/Mental HealthNo
5364SP0807XClinical Nurse SpecialistPsychiatric/Mental Health, Child & AdolescentNo
61041C0700XSocial WorkerClinicalYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1SO9358331MEDICARE ID-TYPE UNSPECIFIEDOHIO

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: 4/28/2024

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