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NPI Code Detail

MEDICARE: TCN BEHAVIORAL HEALTH SERVICES, INC.

MEDICARE: TCN BEHAVIORAL HEALTH SERVICES, INC.
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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2101YM0800XMental Health Counselor
3104100000XSocial Worker
41041C0700XClinical Social Worker
5261QM0850XAdult Mental Health Clinic/Center
6261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center
7320800000XMental Illness Community Based Residential Treatment Facility
8324500000XSubstance Abuse Rehabilitation Facility
9363LP0808XPsychiatric/Mental Health Nurse Practitioner
10261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336118256
Entity Type Code : Organization
Provider Name (Legal Business Name) : TCN BEHAVIORAL HEALTH SERVICES, INC.
Provider Business Mailing Address
First Line : 452 W MARKET ST
Second Line :
City : XENIA
State : OH
Zip : 45385-2815
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 452 W MARKET ST
Second Line :
City : XENIA
State : OH
Zip : 45385-2815
Country : US
Telephone Number : 937-376-8700
Fax Number : 937-376-0113
Authorized Official
Title or Position : DIRECTOR OF SYSTEM OPERATIONS
Name : RANDALL HASKINS
Credential :
Telephone Number : 937-376-8700
Provider Enumeration Date : 03/14/2006
Last Update Date : 08/11/2020

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1215027941 — CHRISTOPHER PINKELMAN LPCC, LICDC
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XENIA, OH
45385-2815
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