NORTHSIDE MENTAL HEALTH CENTER (NPI# 1750671095) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750671095 |
| Entity Type | Organization |
| Organization Name | NORTHSIDE MENTAL HEALTH CENTER |
| Practice Address |
12512 Bruce B Downs Blvd Tampa FL 33612-9209 |
| Practice Telephone | 8139778700 |
| Practice Fax Number | 8139790503 |
| Mailing Telephone | 8139778700 |
| Mailing Fax Number | 8139790503 |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2011-04-07 |
| Authorized Official Name | MS. MARSHA LEWIS BROWN (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8139778700 |
| Authorized Official Credential | L.C.S.W. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | FL | Hospital Units |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437404159 | Northside Mental Health Center | Clinic/Center | 12512 Bruce B Downs Blvd, Tampa, FL 33612-9209 | 2012-07-18 |
| 1750644811 | Northside Mental Health Center | Case Management | 12512 Bruce B Downs Blvd, Tampa, FL 33612-9209 | 2012-06-22 |
| 1033472667 | Northside Mental Health Center | Community/Behavioral Health | 12512 Bruce B Downs Blvd, Tampa, FL 33612-9209 | 2012-06-19 |
| 1659672715 | Northside Mental Health Center | Clinic/Center | 12512 Bruce B Downs Blvd, Tampa, FL 33612-9209 | 2010-11-05 |
| Street Address |
12512 BRUCE B DOWNS BLVD |
| City | TAMPA |
| State | FL |
| Zip Code | 33612-9209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669498002 | Northside Behavioral Health Center, Inc. | Psychiatric Hospital | 12512 Bruce B Downs Blvd, Tampa, FL 33612 | 2006-07-15 |
| 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 |
| 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 | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881632818 | St. Joseph's Hospital, Inc. | Psychiatric Unit | 3001 W Dr Mlk Jr Blvd, Tampa, FL 33607-6307 | 2006-06-03 |
| 1962844167 | West Florida - Mht, LLC | Psychiatric Unit | 2901 W Swann Ave, Tampa, FL 33609-4056 | 2013-07-29 |
| 1336581602 | West Florida - Tch, LLC | Psychiatric Unit | 6001 Webb Rd, Tampa, FL 33615-3241 | 2013-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760810550 | Vipsych Pllc | Psychiatric Unit | 5895 Lake Melrose Dr, Orlando, FL 32829-7690 | 2013-10-15 |
| 1154687382 | Lee Care, Inc. | Psychiatric Unit | 833 Eisenhower Blvd, Lehigh Acres, FL 33974-3603 | 2012-04-02 |
| 1932435187 | The Pavilion At Healthpark, LLC | Psychiatric Unit | 9241 Park Royal Drive, Ft. Myers, FL 33908 | 2009-10-22 |
| 1952634644 | Kareen Aristide | Psychiatric Unit | 851 Nw 151st St, Miami, FL 33169-6103 | 2009-09-12 |
| 1659493476 | University of Miami Hospital and Clinics | Psychiatric Unit | 1475 Nw 12th Ave # C-023a, Miami, FL 33136-1002 | 2007-04-04 |
| 1467527358 | Tania M. Holly | Psychiatric Unit | Uf, Department of Psychiatry 1600 Sw Archer Road, Gainesville, FL 32610 | 2006-11-24 |
| 1457448037 | Baptist Hospital Inc. | Psychiatric Unit | 1101 W Moreno St, Pensacola, FL 32501-2317 | 2006-10-06 |
| 1265529887 | Memorial Hospital West Volusia Inc | Psychiatric Unit | 701 W. Plymouth Avenue, Deland, FL 32720-3236 | 2006-10-06 |
| 1033211180 | Adventist Health System-sunbelt Inc | Psychiatric Unit | 1210 Us 27 N, Lake Placid, FL 33852-7948 | 2006-09-01 |
| 1063422327 | Springbrook Hospital | Psychiatric Unit | 7007 Grove Rd, Brooksville, FL 34609-8610 | 2006-08-09 |
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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.