Healthcare Provider Details
I. General information
NPI: 1194519389
Provider Name (Legal Business Name): BEHAVIORAL HEALTH INNOVATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/04/2025
Last Update Date: 04/04/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
940 E PARK DR STE A
HARRISBURG PA
17111-2800
US
IV. Provider business mailing address
1519 MECKLENBURG HWY UNIT 362
MOORESVILLE NC
28123-2016
US
V. Phone/Fax
- Phone: 989-708-0349
- Fax:
- Phone: 989-708-0349
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YS0200X |
| Taxonomy | School Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041S0200X |
| Taxonomy | School Social Worker |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WP0807X |
| Taxonomy | Child & Adolescent Psychiatric/Mental Health Registered Nurse |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WP0809X |
| Taxonomy | Adult Psychiatric/Mental Health Registered Nurse |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1835P0018X |
| Taxonomy | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1835P1300X |
| Taxonomy | Psychiatric Pharmacist |
| License Number | |
| License Number State | |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QA0000X |
| Taxonomy | Adolescent Medicine (Family Medicine) Physician |
| License Number | |
| License Number State | |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2083P0901X |
| Taxonomy | Public Health & General Preventive Medicine Physician |
| License Number | |
| License Number State | |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 164W00000X |
| Taxonomy | Licensed Practical Nurse |
| License Number | |
| License Number State | |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
| # 12 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0804X |
| Taxonomy | Child & Adolescent Psychiatry Physician |
| License Number | |
| License Number State | |
| # 13 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LC1500X |
| Taxonomy | Community Health Nurse Practitioner |
| License Number | |
| License Number State | |
| # 14 | |
| Primary Taxonomy | N |
| Taxonomy Code | 364SP0807X |
| Taxonomy | Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist |
| License Number | |
| License Number State | |
| # 15 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JOHN
L
OSTROWSKI
JR.
Title or Position: CEO/FOUNDER
Credential: MA, LPC/S
Phone: 616-881-6262