NORTHSIDE BEHAVIORAL HEALTH CENTER, INC. (NPI# 1669498002) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669498002 |
| Entity Type | Organization |
| Organization Name | NORTHSIDE BEHAVIORAL HEALTH CENTER, INC. |
| Other Organization Name | NORTHSIDE MENTAL HEALTH CTR, INC |
| Practice Address |
12512 Bruce B Downs Blvd Tampa FL 33612 |
| Mailing Address |
12512 Bruce B Downs Blvd Tampa FL 33612-9209 |
| Practice Telephone | 8139778700 |
| Practice Fax Number | 8139712029 |
| Mailing Telephone | 8139778700 |
| Mailing Fax Number | 8139712029 |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2019-09-04 |
| Authorized Official Name | ASHLEY MORROW (BUSINESS MANAGER) |
| Authorized Official Telephone | 8139778700 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 283Q00000X | Psychiatric Hospital | Hospitals | ||
| N | 208D00000X | General Practice | Allopathic & Osteopathic Physicians | ||
| N | 251B00000X | Case Management | Agencies | ||
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 060370800 | 05 | |
| FL | 060370801 | 05 |
| Other Name | Type Code |
|---|---|
| Northside Mental Health Ctr, Inc | Former Legal Business Name - Organization |
| Street Address |
12512 BRUCE B DOWNS BLVD |
| City | TAMPA |
| State | FL |
| Zip Code | 33612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205327558 | Savannah Sterns | Counselor | 12512 Bruce B Downs Blvd, Tampa, FL 33612-9209 | 2018-05-22 |
| 1902303357 | Amber E Holbin | Counselor | 12512 Bruce B Downs Blvd, Tampa, FL 33612-9209 | 2018-04-11 |
| 1346743036 | Anthony Jose Silverio | Counselor | 12512 Bruce B Downs Blvd, Tampa, FL 33612-9209 | 2018-03-09 |
| 1063914422 | Brittany Melendez | Counselor | 12512 Bruce B Downs Blvd, Tampa, FL 33612-9209 | 2018-03-01 |
| 1134643463 | Kamille Naomi Harris | Counselor | 12512 Bruce B Downs Blvd, Tampa, FL 33613 | 2017-07-28 |
| 1053832022 | Kelly Elizabeth Solberg | Social Worker | 12512 Bruce B Downs Blvd, Tampa, FL 33612-9209 | 2017-06-29 |
| 1144755968 | Rossen Munroe | Counselor | 12512 Bruce B Downs Blvd, Tampa, FL 33612-9209 | 2017-04-30 |
| 1396277026 | Anne Marie Bowlin | Licensed Practical Nurse | 12512 Bruce B Downs Blvd, Tampa, FL 33612-9209 | 2017-03-31 |
| 1902341720 | Joseph Marten | Registered Nurse | 12512 Bruce B Downs Blvd, Tampa, FL 33612-9209 | 2017-01-03 |
| 1942742457 | Linton Anthony Westcarr | Counselor | 12512 Bruce B Downs Blvd, Tampa, FL 33612-9209 | 2016-11-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689286767 | Daniel Jimenez | Physical Therapist | 13000 Bruce B Downs Blvd, Tampa, Fl, Tampa, FL 33612 | 2020-08-19 |
| 1700426830 | Taz Stacy | Behavior Technician | 2701 University Square Drive, Tampa, FL 33612 | 2020-01-07 |
| 1841853215 | Eric Austen Keeler | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd, Mdc5, Tampa, FL 33612 | 2019-04-20 |
| 1346700242 | Caitlyn Victoria Cartwright | Student in an Organized Health Care Education/Training Program | 12901 Bruce B. Downs Blvd., Mdc5, Tampa, FL 33612 | 2019-03-25 |
| 1720552953 | Marijo Bilitski | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd # Blvd5, Tampa, FL 33612 | 2019-01-22 |
| 1790259190 | Belkis Aleman | Nurse Practitioner | 205 E Busch Blvd, Tampa, FL 33612 | 2019-01-18 |
| 1811469133 | Stephanie Stegner | Physician Assistant | 12901 Bruce B Downs Blvd Mdc 5, Tampa, FL 33612 | 2018-12-27 |
| 1053889857 | Alysia Heather Siegel | Psychologist | 1300 Bruce B. Downs Boulevard, 116b, Tampa, FL 33612 | 2018-11-09 |
| 1295202489 | Daisy Baby Pulinilkumkalayil | Nurse Practitioner | 1426 W. Bush Blvd. Suite #105, Suite #105, Tampa, FL 33612 | 2018-10-26 |
| 1649745258 | Rachel Rene Shelton | Specialist/Technologist | Orthopedics and Sports Medicine, 13330 Usf Laurel Drive, Tampa, FL 33612 | 2018-10-10 |
| Find all providers in zip 33612 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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| 1003477662 | Embracing Changes Center for Wellness | Clinic/Center | 2203 N Lois Ave Ste 903, Tampa, FL 33607-2306 | 2019-06-25 |
| 1508324781 | Breakthrough Counseling Services, LLC | Clinic/Center | 3105 W Azeele St, Tampa, FL 33609-3089 | 2019-03-07 |
| 1013405281 | Crudup Psychological Services LLC | Clinic/Center | 10001 Cross Creek Blvd, Tampa, FL 33647-2581 | 2018-04-24 |
| 1346753134 | Mental Fitness Group, LLC | Clinic/Center | 8875 Hidden River Pkwy Ste 300, Tampa, FL 33637 | 2017-11-15 |
| Find all providers in TAMPA | ||||
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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.