DataLabs

datalabs.health made in the usa

Contact us Sign in | Documentation |

divider

Medicare/Medicaid Verification Programs divider

divider

Medicare Verification Program divider

divider

1134158314

NPI Code Detail

MEDICARE: DEERFIELD BEHAVIORAL HEALTH OF WARREN, LLC

MEDICARE: DEERFIELD BEHAVIORAL HEALTH OF WARREN, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0804X	Child & Adolescent Psychiatry Physician	MD425828	PA
2	2084P0800X	Psychiatry Physician	MD016835E	PA
3	101YP2500X	Professional Counselor	PC001117	PA
4	2084P0800X	Psychiatry Physician	MD055978L	PA
5	104100000X	Social Worker	SW123097	PA
6	363L00000X	Nurse Practitioner	UP006505B	PA
7	2084P0802X	Addiction Psychiatry Physician	MD055978L	PA
8	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center	627023	PA
9	101YP2500X	Professional Counselor	PC004260	PA
10	2084P0800X	Psychiatry Physician	MD042901L	PA
11	2084P0800X	Psychiatry Physician	MD051025L	PA
12	2084P0800X	Psychiatry Physician	MD061131L	PA
13	103TC0700X	Clinical Psychologist	PS006787L	PA
14	1041C0700X	Clinical Social Worker	CW013526	PA
15	2084P0800X	Psychiatry Physician	MD050021L	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	CD5207	OTHER	PA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0050598001	OTHER	PA	UNIVERA HEALTH CARE
3	330194	OTHER		VALUE OPTIONS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	0828	OTHER	PA	HIGHMARK FACILITY
9	1436227	OTHER	PA	KEYSTONE HIGHMARK
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	1436176	OTHER	PA	HIGHMARK BLUE SHIELD

General Provider Information

NPI Number	:	1134158314
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEERFIELD BEHAVIORAL HEALTH OF WARREN, LLC

Provider Business Mailing Address
First Line	:	1885 MARKET ST
Second Line	:
City	:	WARREN
State	:	PA
Zip	:	16365-1277
Country	:	US
Telephone Number	:	814-723-5545
Fax Number	:	814-723-6355

Provider Business Practice Location Address
First Line	:	1885 MARKET ST
Second Line	:
City	:	WARREN
State	:	PA
Zip	:	16365-1277
Country	:	US
Telephone Number	:	814-723-5545
Fax Number	:	814-723-6355

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. JOHN JOHN
Credential	:	MD
Telephone Number	:	814-723-5545

Provider Enumeration Date	:	07/01/2006
Last Update Date	:	03/06/2026

Similar Medicare Providers

1497789507 — JOHN PUTHENPURACKAL JOHN MD
Practice Location Address:

1885 MARKET ST
WARREN, PA
16365-1277

Practice Phone: 814-723-5545
Practice Fax: 814-723-6355

1962532374 — DEERFIELD BEHAVIORAL HEALTH OF WARREN
Practice Location Address:

1885 MARKET ST
WARREN, PA
16365-1277

Practice Phone: 814-723-5545
Practice Fax: 814-362-5245

1043331994 — CHILDREN'S CENTER FOR TREATMENT AND EDUCATION
Practice Location Address:

1885 MARKET ST
WARREN, PA
16365-1277

Practice Phone: 814-723-1832
Practice Fax: 814-362-5245

1255531489 — JILL M GORTON CRNP
Practice Location Address:

1885 MARKET ST
WARREN, PA
16365-1277

Practice Phone: 814-726-4047
Practice Fax: 814-726-4045

1043863947 — CHILDREN'S CENTER FOR TREATMENT AND EDUCATION
Practice Location Address:

1885 MARKET ST
WARREN, PA
16365-1277

Practice Phone: 814-817-1400
Practice Fax: 814-362-5245

1003416165 — ALEXIS ROSE VAVALA
Practice Location Address:

1885 MARKET ST
WARREN, PA
16365-1277

Practice Phone: 814-723-1832
Practice Fax:

Directions to “DEERFIELD BEHAVIORAL HEALTH OF WARREN, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.