PHOENIX BEHAVIORAL HEALTH LLC (NPI# 1750891990) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750891990 |
| Entity Type | Organization |
| Organization Name | PHOENIX BEHAVIORAL HEALTH LLC |
| Practice Address |
1014 Whitehead Road Ext Ewing NJ 08638-2406 |
| Practice Telephone | 6097713777 |
| Mailing Telephone | 6097713777 |
| Enumeration Date | 2017-10-02 |
| Last Update Date | 2017-10-02 |
| Authorized Official Name | PHIL FUHRER (CFO) |
| Authorized Official Telephone | 6097713777 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0006X |
Pediatrics Specialization: Developmental – Behavioral Pediatrics |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 0468665 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437764354 | Phoenix Behavioral Health LLC | Clinic/Center | 102 Browning Ln Ste 2, Cherry Hill, NJ 08003-3195 | 2020-09-09 |
| 1144787078 | Phoenix Behavioral Health LLC | Clinic/Center | 102 Browning Ln Ste C3, Cherry Hill, NJ 08003-3195 | 2019-02-27 |
| 1275938193 | Phoenix Behavioral Health LLC | Clinic/Center | 1014 Whitehead Road Ext, Ewing, NJ 08638-2406 | 2014-11-04 |
| 1992267132 | Phoenix Behavioral Health LLC | Clinic/Center | 1014 Whitehead Road Ext, Ewing, NJ 08638-2406 | 2019-04-05 |
| 1073070900 | Phoenix Behavioral Health LLC | Clinic/Center | 102 Browning Ln Ste C3, Cherry Hill, NJ 08003-3195 | 2019-02-27 |
| 1528561933 | Phoenix Behavioral Health LLC | In Home Supportive Care | 1014 Whitehead Road Ext, Ewing, NJ 08638-2406 | 2018-03-12 |
| 1013427251 | Phoenix Behavioral Health LLC | Clinic/Center | 1014 Whitehead Road Ext, Ewing, NJ 08638-2406 | 2017-10-02 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PHOENIX BEHAVIORAL HEALTH LLC | 1014 Whitehead Road Ext, Ewing, NJ 08638-2406 |
| Virginia Business Entities | Phoenix Behavioral Health LLC | 6504 Woodlake Village Circle, Midlothian, Virginia 23112 |
| Street Address |
1014 WHITEHEAD ROAD EXT |
| City | EWING |
| State | NJ |
| Zip Code | 08638-2406 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275938193 | Phoenix Behavioral Health LLC | Clinic/Center | 1014 Whitehead Road Ext, Ewing, NJ 08638-2406 | 2014-11-04 |
| 1427611185 | Phoenix Support Services LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1014 Whitehead Road Ext, Ewing, NJ 08638-2406 | 2019-04-18 |
| 1992267132 | Phoenix Behavioral Health LLC | Clinic/Center | 1014 Whitehead Road Ext, Ewing, NJ 08638-2406 | 2019-04-05 |
| 1659869576 | Justin Dunn | Counselor | 1014 Whitehead Road Ext, Ewing, NJ 08638-2406 | 2018-04-26 |
| 1316435266 | Parizatis R Alaie | Counselor | 1014 Whitehead Road Ext, Ewing, NJ 08638-2406 | 2018-04-26 |
| 1255829263 | Alaina Chapman | Counselor | 1014 Whitehead Road Ext, Ewing, NJ 08638-2406 | 2018-04-25 |
| 1811485824 | Himie Wesley | Counselor | 1014 Whitehead Road Ext, Ewing, NJ 08638-2406 | 2018-04-25 |
| 1881182897 | Francesca Scirocco | Counselor | 1014 Whitehead Road Ext, Ewing, NJ 08638-2406 | 2018-04-25 |
| 1386132397 | Gabrielle Petosa | Counselor | 1014 Whitehead Road Ext, Ewing, NJ 08638-2406 | 2018-04-25 |
| 1356839369 | Dayna Giel | Counselor | 1014 Whitehead Road Ext, Ewing, NJ 08638-2406 | 2018-04-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114493244 | Dungarvin New Jersey, LLC - Whitehead II | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1015 Whitehead Road Extension, Apt 209 & 217, Ewing, NJ 08638 | 2018-10-16 |
| 1285145714 | Lifeties Inc. | Social Worker | 2205 Pennington Road, Trenton, NJ 08638 | 2017-10-24 |
| 1720502792 | Rola Behavioral Services LLC | Registered Nurse | 1676 North Olden Ave, Bldg 1, Ewing, NJ 08638 | 2017-08-01 |
| 1295264562 | Ijeoma Audrey Okpara | Behavior Technician | 67 Oak Street, Trenton, NJ 08638 | 2017-06-08 |
| 1962878736 | Meals On Wheels of Mercer County, Inc. | Home Delivered Meals | 320 Hollowbrook Drive, Ewing, NJ 08638 | 2015-08-17 |
| 1770917031 | Erica Jane Mclaughlin | Physician Assistant | 750 Bruinswick Ave, Trenton, NJ 08638 | 2013-08-22 |
| 1396013975 | Capital Health | General Acute Care Hospital | 832 Brunswick Ave., Trenton, NJ 08638 | 2011-12-09 |
| 1174800197 | Kashif Syed Anwar | Family Medicine | 1450 Parkside Ave Ste 5, Ewing, NJ 08638 | 2011-11-04 |
| 1235394578 | Neuromechanical Pain Management Associates PC | Chiropractor | 1330 Calhoun Street, Suite 2, Trenton, NJ 08638 | 2008-07-25 |
| 1861684185 | Youth Education and Transition Services | Counselor | 702 Brunswick Ave, Trenton, NJ 08638 | 2007-08-10 |
| Find all providers in zip 08638 | ||||
| Taxonomy Code | 2080P0006X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Developmental – Behavioral Pediatrics |
| A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed, 3/26/2008: definition corrected] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427367440 | Maureen Hoey | Pediatrics | 104 Cranford Ave, Cranford, NJ 07016-2408 | 2010-09-27 |
| 1548427420 | Manuel Jimenez | Pediatrics | 89 French St Rm 1349, New Brunswick, NJ 08901-1935 | 2008-05-19 |
| 1265589600 | Margaret Kelly Downey | Pediatrics | 110 Hazel Ct, Norwood, NJ 07648-1817 | 2007-01-05 |
| 1982798237 | Dorothy W. Bryan | Pediatrics | 953 Garfield Avenue, Jersey City, NJ 07304 | 2006-10-03 |
| 1952493967 | Batul S Ladak | Pediatrics | 50 Market Street, Second Floor, Saddle Brook, NJ 07663 | 2006-09-28 |
| 1235233248 | Ffrancine M Siegel-stein | Pediatrics | 263 Arch Rd, Englewood, NJ 07631-4402 | 2006-09-11 |
| 1801847462 | Marivic Santiago | Pediatrics | 140 E Ridgewood Avenue, Suite 480n, Paramus, NJ 07652 | 2006-05-16 |
| 1871561266 | Kathleen Selvaggi-fadden | Pediatrics | 435 South St Ste 250, Morristown, NJ 07960-6477 | 2006-03-10 |
| 1295371441 | Hunterdon Medical Center | Pediatrics | 190 Route 31, Flemington, NJ 08822-5773 | 2019-11-22 |
| 1932762002 | Clarity Psychiatric Care | Pediatrics | 31 Kings Hwy E, Haddonfield, NJ 08033-2001 | 2019-04-15 |
| Find all providers with the same taxonomy | ||||
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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.