DEERFIELD BEHAVIORAL HEALTH OF WARREN, LLC (NPI# 1134158314) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134158314 |
| Entity Type | Organization |
| Organization Name | DEERFIELD BEHAVIORAL HEALTH OF WARREN, LLC |
| Practice Address |
514 W 3rd Ave Warren PA 16365-2201 |
| Mailing Address |
1003 Pennsylvania Ave W Fl 2 Warren PA 16365-1876 |
| Practice Telephone | 8147235545 |
| Practice Fax Number | 8147236355 |
| Mailing Telephone | 8147235545 |
| Mailing Fax Number | 8147236355 |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2020-10-05 |
| Authorized Official Name | ERNESTO ROEDERER (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 8147235545 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YP2500X |
Counselor Specialization: Professional |
PC004260 | PA | Behavioral Health & Social Service Providers |
| N | 101YP2500X |
Counselor Specialization: Professional |
PC001117 | PA | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
PS006787L | PA | Behavioral Health & Social Service Providers |
| N | 104100000X | Social Worker | SW123097 | PA | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
CW013526 | PA | Behavioral Health & Social Service Providers |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
MD055978L | PA | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
MD016835E | PA | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
MD051025L | PA | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
MD042901L | PA | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
MD061131L | PA | Allopathic & Osteopathic Physicians |
| N | 2084P0802X |
Psychiatry & Neurology Specialization: Addiction Psychiatry |
MD055978L | PA | Allopathic & Osteopathic Physicians |
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
MD425828 | PA | Allopathic & Osteopathic Physicians |
| N | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
627023 | PA | Ambulatory Health Care Facilities |
| N | 363L00000X | Nurse Practitioner | UP006505B | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
MD050021L | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 0015930840009 | 05 | |
| VALUE OPTIONS | 330194 | 01 | |
| PA | 0015930840011 | 05 | |
| PA | HIGHMARK BLUE SHIELD | 1436176 | 01 |
| PA | RAILROAD MEDICARE | CD5207 | 01 |
| PA | KEYSTONE HIGHMARK | 1436227 | 01 |
| PA | 0015930840010 | 05 | |
| PA | 0015930840012 | 05 | |
| PA | HIGHMARK FACILITY | 0828 | 01 |
| PA | 0015930840007 | 05 | |
| PA | UNIVERA HEALTH CARE | 0050598001 | 01 |
| Street Address |
514 W 3RD AVE |
| City | WARREN |
| State | PA |
| Zip Code | 16365-2201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114548468 | Karen Marie Kline | Nurse Practitioner | 514 W 3rd Ave, Warren, PA 16365-2245 | 2020-04-28 |
| 1689032294 | Karen Ashbaugh | Social Worker | 514 W 3rd Ave, #1, Warren, PA 16365-2201 | 2016-02-10 |
| 1568892024 | Kathleen Patterson | Nurse Practitioner | 514 W 3rd Ave, Warren, PA 16365-2201 | 2013-11-20 |
| 1033549605 | Kelly Allen | Nurse Practitioner | 514 W 3rd Ave, Warren, PA 16365-2201 | 2013-11-19 |
| 1881934065 | Elizabeth Cleland Greville | Social Worker | 514 W 3rd Ave, Warren, PA 16365-2201 | 2013-02-25 |
| 1982913554 | Richard S Barton | Nurse Practitioner | 514 W 3rd Ave, Warren, PA 16365-2201 | 2010-09-30 |
| 1043378854 | Robert T Ross | Social Worker | 514 W 3rd Ave, Warren, PA 16365-2201 | 2006-12-05 |
| 1417015108 | Tracy Passaro | Counselor | 514 W 3rd Ave, Warren, PA 16365-2201 | 2006-12-05 |
| 1306904313 | Patricia Calhoun Gabreski | Social Worker | 514 W 3rd Ave, Warren, PA 16365-2201 | 2006-12-04 |
| 1497789507 | John Puthenpurackal John | Psychiatry & Neurology | 514 W 3rd Ave, Warren, PA 16365-2201 | 2006-07-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932712759 | James Hickey | Dentist | 94 Egypt Hollow Rd, Warren, PA 16365 | 2020-08-31 |
| 1437674579 | Theresa Elizabeth Cook | Speech-Language Pathologist | Rehabworks At Warren General Hospital, Two Crescent Park West, Warren, PA 16365 | 2017-08-10 |
| 1891160982 | Vanessa Frank Humphrey | Occupational Therapy Assistant | 682 Pleasant Drive, Warren, PA 16365 | 2015-12-01 |
| 1740651967 | John L. Harrington | Psychiatry & Neurology | 4 Second Ave. Apt. #2, Warren, PA 16365 | 2015-10-14 |
| 1992046569 | Carrie Lynn Vaughn | Physical Therapy Assistant | 1048 Pennslvania Ave West, Warren, PA 16365 | 2013-03-07 |
| 1750664488 | William Frederick Menz | Pharmacist | 2901 Market Street, (walmart), Warren, PA 16365 | 2011-09-20 |
| 1669617296 | Donald Nicholas Vandamia | Family Medicine | 64 Leda Lane, Warren, PA 16365 | 2008-12-11 |
| 1013187558 | Chad Michael Ristau | Nurse Anesthetist, Certified Registered | 2 Crescent Park West., Warren General Hospital, Warren, PA 16365 | 2008-03-11 |
| 1407072473 | Family Physical Therapy | Physical Therapist | 218 Liberty St, Warren, PA 16365 | 2007-04-18 |
| 1801927330 | Wal-mart Stores East, L.p. | Technician/Technologist | 2901 Market St., Warren, PA 16365 | 2007-03-08 |
| Find all providers in zip 16365 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| 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. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740651967 | John L. Harrington | Psychiatry & Neurology | 4 Second Ave. Apt. #2, Warren, PA 16365 | 2015-10-14 |
| 1952727323 | Shilin R Pandya | Psychiatry & Neurology | 27 Mountain Blvd Ste 3, Warren, NJ 07059-5605 | 2014-03-10 |
| 1376688770 | David Schwartz Md PC | Psychiatry & Neurology | 12434 12 Mile Road, Suite 204, Warren, MI 48093 | 2007-02-21 |
| 1730192832 | Anthony Petrilli | Psychiatry & Neurology | 27550 Schoenherr Rd, Suite 300, Warren, MI 48088-4798 | 2006-08-14 |
| 1578575106 | Chilakamarri Ramesh | Psychiatry & Neurology | 11900 E Twelve Mile Rd, Suite #111, Warren, MI 48093-3472 | 2006-08-12 |
| 1932110319 | Shin Jae Lee | Psychiatry & Neurology | 1400 Tod Ave Nw, Warren, OH 44485-2483 | 2006-08-10 |
| 1740206168 | Lily Ann Marie Tencza | Psychiatry & Neurology | 28000 Dequindre Rd, Warren, MI 48092-2468 | 2006-07-15 |
| 1780649921 | Eleanor Judith Kulis | Psychiatry & Neurology | 29856 Schoenherr Rd, Ste IIi, Warren, MI 48088 | 2006-04-19 |
| 1578528725 | Barb Thielman Beebe | Psychiatry & Neurology | 29856 Schoenherr Road, Suite IIi, Warren, MI 48093 | 2006-04-19 |
| 1144206087 | Brahmaiah Tandra | Psychiatry & Neurology | 8577 E Market St, Warren, OH 44484-2345 | 2005-12-22 |
| Find all providers in WARREN | ||||
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| 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.