LICKING MEMORIAL PROFESSIONAL CORPORATION NPI 1932149150

NPI Information

  • NPI: 1932149150
  • Provider Name: LICKING MEMORIAL PROFESSIONAL CORPORATION
  • Classification: Psychiatry & Neurology - 2084P0800X
  • Specialization: Psychiatry
  • Entity Type: Organization
  • Doing Business As: LICKING MEMORIAL BEHAVIORAL HEALTH
  • Address: 200 MESSIMER DR
    NEWARK, OH
    ZIP 43055
  • Phone: (740) 348-4870

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NPI Details

LICKING MEMORIAL PROFESSIONAL CORPORATION is a psychiatry psychiatry neurology in Newark, OH. The provider is a Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. LICKING MEMORIAL PROFESSIONAL CORPORATION NPI is 1932149150. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Licking Memorial Behavioral Health.

The provider's business location address is:

200 MESSIMER DR
NEWARK, OH
ZIP 43055-627
Phone: (740) 348-4870
Fax: (740) 348-4871

The provider's authorized official is Robert A. Montagnese .
The authorized official title is Executive Vice President and has the following contact phone number (740) 348-4000.

The enumeration date for this NPI number is 6/7/2006 and was last updated on 8/22/2020.

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
12084P0800XPsychiatry & NeurologyPsychiatryYes

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
10118992MEDICAIDOHIO

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: 3/30/2025

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