NPI Code Detail JSON Logo

1487570057 NPI number — NORTHERN KENTUCKY BEHAVIORAL, LLC

NPI Number: 1487570057
Health Care Provider/Practitioner: NORTHERN KENTUCKY BEHAVIORAL, LLC

Information about “1487570057” NPI (NORTHERN KENTUCKY BEHAVIORAL, LLC) exists in 1487570057 in HTML format HTML  |  1487570057 in plain Text format TXT  |  1487570057 in PDF (Portable Document Format) PDF  |  1487570057 in an XML format XML  formats.

NPI Number : 1487570057 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1487570057",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "NORTHERN KENTUCKY BEHAVIORAL, LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "820 DOLWICK DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ERLANGER",
    "MailingAddressStateName": "KY",
    "MailingAddressPostalCode": "41018-2774",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "859-429-5188",
    "MailingAddressFaxNumber": "859-578-2875",
    "FirstLinePracticeLocationAddress": "820 DOLWICK DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ERLANGER",
    "PracticeLocationAddressStateName": "KY",
    "PracticeLocationAddressPostalCode": "41018-2774",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "859-429-5188",
    "PracticeLocationAddressFaxNumber": "859-578-2875",
    "EnumerationDate": "06/26/2026",
    "LastUpdateDate": "06/26/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "MCCLENDON",
    "AuthorizedOfficialFirstName": "KEANNA",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "DIRECTOR OF PROVIDER CREDENTIALING",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "678-698-2070",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "2084P0802X",
          "TaxonomyName": "Addiction Psychiatry Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2084P0804X",
          "TaxonomyName": "Child & Adolescent Psychiatry Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LP0808X",
          "TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2084P0800X",
          "TaxonomyName": "Psychiatry Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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