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General NPI Number Information
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NPI Number | 1376436956
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Entity Type | Organization
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Legal Business Name | DOT BEHAVIORAL HEALTH SERVICES
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 619 SHARON LN
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City | PHILADELPHIA
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State | PA
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Zip | 19115-3516
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Country | US
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Telephone | 484-665-2351
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Fax |
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Provider Business Mailing Address
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Address Line | 619 SHARON LN
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City | PHILADELPHIA
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State | PA
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Zip | 19115-3516
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | FOLAKEMI AKINTOMIDE
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Credential |
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Telephone | 484-665-2351
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 364SP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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