PHS BEHAVIORAL MEDICINE NPI 1396012837

NPI Information

NPI: 1396012837
Provider Name: PHS BEHAVIORAL MEDICINE

Other Name: PROVIDENCE HEALTH SERVICES

Classification: Psychiatry & Neurology - 2084A0401X
Entity Type: Organization

Specialization: Addiction Medicine

Address:
1053 BUCHANAN ST NE
SUITE 055
WASHINGTON, DC
ZIP 20017
Phone: (202) 269-7626
Get Directions

PHS BEHAVIORAL MEDICINE is an addiction medicine psychiatry neurology in Washington, DC. The provider is 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 NPI is 1396012837. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Providence Health Services.

The provider's business location address is:

1053 BUCHANAN ST NE
SUITE 055
WASHINGTON, DC
ZIP 20017-712
Phone: (202) 269-7626
Fax: (202) 269-7616

The provider's authorized official is Charles F Haberkern .
The authorized official title is Vp and has the following contact phone number (202) 854-4255.

The enumeration date for this NPI number is 11/29/2011 and was last updated on 9/6/2016.

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
1	2084N0400X	Psychiatry & Neurology	Neurology	HFD01-0212	DISTRICT OF COLUMBIA	No
2	282N00000X	General Acute Care Hospital		HFD01-0112	DISTRICT OF COLUMBIA	No
3	2084A0401X	Psychiatry & Neurology	Addiction Medicine	HFD01-0212	DISTRICT OF COLUMBIA	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
1	09810714	MEDICAID	VIRGINIA
2	090006	MEDICARE PIN
3	029833400	MEDICAID	DISTRICT OF COLUMBIA
4	005145400	MEDICAID	MARYLAND

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

NPI Synchronization or Removal

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