PROVIDENCE HEALTH SERVICES, INC
PHS OUTPATIENT BEHAVIORAL HEALTH · Counselor

Address: 1140 Varnum St Ne Ste 100, Washington, DC 20017

PROVIDENCE HEALTH SERVICES, INC (NPI# 1609031632) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1609031632
Entity Type Organization
Organization Name PROVIDENCE HEALTH SERVICES, INC
Other Organization Name PHS OUTPATIENT BEHAVIORAL HEALTH (Doing Business As Name)
Practice Address 1140 Varnum St Ne Ste 100
Washington
DC 20017
Practice Telephone 2028547623
Practice Fax Number 2028547616
Mailing Address 1150 Varnum St Ne
St Catherines Hall 102
Washington
DC 20017-2180
Mailing Telephone 2028544069
Mailing Fax Number 2022697825
Enumeration Date 2008-07-18
Last Update Date 2018-08-22
Authorized Official Telephone 4103683162
Is Organization Subpart Y
Parent Organization Name PROVIDENCE HOSPITAL

Taxonomy

Primary Taxonomy Code Classification Taxonomy Group License Number License State Grouping
N 101Y00000X Counselor 193200000X MULTI-SPECIALTY GROUP HFD01-0212 DC Behavioral Health & Social Service Providers
N 103T00000X Psychologist 193200000X MULTI-SPECIALTY GROUP HFD01-0212 DC Behavioral Health & Social Service Providers
N 104100000X Social Worker 193200000X MULTI-SPECIALTY GROUP HFD01-0212 DC Behavioral Health & Social Service Providers
N 2084A0401X Psychiatry & Neurology
Specialization: Addiction Medicine
193200000X MULTI-SPECIALTY GROUP HFD01-0212 DC Allopathic & Osteopathic Physicians
N 2084B0040X Psychiatry & Neurology
Specialization: Behavioral Neurology & Neuropsychiatry
193200000X MULTI-SPECIALTY GROUP HFD01-0212 DC Allopathic & Osteopathic Physicians
Y 2084N0400X Psychiatry & Neurology
Specialization: Neurology
193200000X MULTI-SPECIALTY GROUP HFD01-0212 DC Allopathic & Osteopathic Physicians

Other Provider Identifiers

Identifier State Issuer Type Code
985415100 MD MEDICAID

Other Provider/Organization Names

Other Name Type Code
PHS Outpatient Behavioral Health Doing Business As Name

Providers with the same name

NPI Name Taxonomy Address Enumeration
1285208009 Providence Health Services, Inc · The Providence Diagnostic Imaging Center Clinic/Center - Magnetic Resonance Imaging (MRI) 1150 Varnum St Ne Ste 2, Washington, DC 20017-2104 2021-05-17
1598313595 Providence Health Services, Inc · The Providence Diagnostic Imaging Center Clinic/Center - Magnetic Resonance Imaging (MRI) 1150 Varnum St Ne Ste 1, Washington, DC 20017-2104 2019-09-03
1356859334 Providence Health Services, Inc · Phs Cardiology Specialist 1150 Varnum St Ne Ste 300, Washington, DC 20017-2180 2018-01-12
1740795293 Providence Health Services, Inc · Phs Anesthesia Anesthesiology 1150 Varnum St Ne, Washington, DC 20017-2104 2017-12-06
1679087365 Providence Health Services, Inc · Phs Occupational Health/Wellness Clinic/Center - Occupational Medicine 1150 Varnum St Ne, Washington, DC 20017-2104 2017-11-17
1730690801 Providence Health Services, Inc · Phs Unity Healthcare Parkside Radiology Clinic/Center - Radiology 765 Kenilworth Ter Ne, Washington, DC 20019-1898 2017-10-17
1972012615 Providence Health Services, Inc · Phs Gyn Group Obstetrics & Gynecology - Gynecology 1150 Varnum St Ne, St Catherine's Hall, 2nd Floor, Washington, DC 20017-2107 2017-09-26
1689005720 Providence Health Services, Inc Orthopaedic Surgery - Sports Medicine 1160 Varnum St Ne, Depaul 312, Washington, DC 20017-2107 2013-11-27
1366710766 Providence Health Services, Inc · Phs Otolaryngology Pmb200 Otolaryngology 1140 Varnum St Ne, Pmb 200, Washington, DC 20017-2151 2011-12-13
1619245222 Providence Health Services, Inc · Providence Health Services Family Medicine 128 M St Nw, Washington, DC 20001-1205 2011-12-09
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Office Location

Street Address 1140 VARNUM ST NE STE 100
City WASHINGTON
State DC
Zip Code 20017

Providers in the same zip code prefix

NPI Name Taxonomy Address Enumeration
1447572094 Gerald P. Batipps, Md, PC Specialist 1140 Varnum Street, Ne, 208-A, Washington, DC 20017 2010-02-24
1033580626 Specialized Education of Dc, Inc. · High Road School Local Education Agency (LEA) 711-A Edgewood Street, Ne, Washington, DC 20017 2015-10-08
1134638042 Jane Hayashi-Kim Speech-Language Pathologist 3910 9th St Ne, Apartment 3, Washington, DC 20017 2017-09-22
1417479197 Javalin Singh Home Health Aide Hsc Pediatric Center 1731 Bunker Hill Rd, Washington, DC 20017 2017-07-13
1013475284 Raphaelia Agnes Johnson-Phillips Technician - Personal Care Attendant 440 Taylor St. Ne Building B Apt 22, Washington Dc, DC 20017 2019-03-06
1063764553 Patience Walajieh Cho Home Health Aide 611 Edgewood St Ne, Washington, DC 20017 2012-10-08
1548577505 My Parent's Homes,Llc Community Based Residential Treatment Facility, Mental Illness 1235 Irving Street,Ne, Washington, DC 20017 2010-09-10
1568727956 Tigest Tesfawe Home Health Aide 3011 7th Ne, Washington, DC 20017 2012-07-11
1144671603 Paulette Clayton Home Health Aide 1731 Bunker Hill Road, Ne, Hsc Home Care, LLC, Washington, DC 20017 2016-06-27
1386174175 Genevieve Wells Home Health Aide 601 Edgewood St. Ne, Apt 706, Washington, DC 20017 2017-06-14
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Taxonomy Information

Taxonomy Code 101Y00000X
Grouping Behavioral Health & Social Service Providers
Classification Counselor

Taxonomy Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification.
Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1164093357 Lauren Ostapowicz Counselor 50 E Wylie Ave # Units23, Washington, PA 15301-2059 2021-07-08
1144891540 Taylor L Venetian Counselor 50 E Wylie Ave Ste 2&3, Washington, PA 15301-2059 2021-07-07
1215506225 Tasha Milstead Counselor 900 Varney St Se Apt 116, Washington, DC 20032-4314 2021-06-23
1093382756 Cornerstone Kazen Co. Counselor 1835 7th St Nw Ste 126, Washington, DC 20001-3107 2021-06-09
1417532680 Crishone C Johnson Counselor 5448 Bass Pl Se, Washington, DC 20019-6370 2021-03-10
1881289890 Mirta Lisso Carruthers Counselor 6th and Bryant Streets, Washington, DC 20059-0001 2021-03-02
1073105359 Victoria Ashley Altenord Counselor 2501 Good Hope Rd Se, Washington, DC 20020-3011 2021-02-08
1003406315 Lili Johnson Counselor 441 21st St Ne, Washington, DC 20002-4705 2021-01-20
1760084164 Keyona M Fowler Counselor 116 T St Ne Apt 437, Washington, DC 20002-5132 2020-11-10
1952909400 Garrison Dugger Counselor 2502 18th St Se, Washington, DC 20020-3214 2020-10-15
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Competitor

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City WASHINGTON
Zip Code 20017

Providers with similar names

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1962078394 Behavioral Health Outpatient, LLC Substance Abuse Rehabilitation Facility 2908 S 29th St Ste B, Ashland, KY 41102-5912 2021-05-27
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1336714005 Behavioral Health Outpatient, LLC Substance Abuse Rehabilitation Facility 260 Evans Ave Ste A, Mt Sterling, KY 40353-9700 2021-05-25
1578154084 A-Z Behavioral Health Outpatient Center Community/Behavioral Health 4045 W Bell Rd Apt 1008, Phoenix, AZ 85053-2735 2021-01-27
1376117325 Providence Health & Services Washington Orthopaedic Surgery 820 S Mcclellan St Ste 118, Spokane, WA 99204-2446 2021-05-14

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.