=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023821170
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NP ADVANTAGE MENTAL HEALTH AND RECOVERY SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/30/2025
-----------------------------------------------------
Last Update Date | 01/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 670 MERIDIAN WAY STE 147
-----------------------------------------------------
City | WESTERVILLE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43082-2301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-296-4941
-----------------------------------------------------
Fax | 614-808-4695
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 670 MERIDIAN WAY STE 147
-----------------------------------------------------
City | WESTERVILLE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43082-2301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-296-4941
-----------------------------------------------------
Fax | 614-808-4695
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MRS. PATRICIA BAILEY
-----------------------------------------------------
Credential | PHD PMHNP-BC
-----------------------------------------------------
Telephone | 614-296-4941
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2084P0802X
-----------------------------------------------------
Taxonomy Name | Addiction Psychiatry Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 2084A0401X
-----------------------------------------------------
Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------