MEDICARE: MERCY HEALTH BEHAVIORAL HOSPITAL PHYSICIAN GROUP LLC

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
1	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1356203491
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERCY HEALTH BEHAVIORAL HOSPITAL PHYSICIAN GROUP LLC

Provider Business Mailing Address
First Line	:	330 SEVEN SPRINGS WAY
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-5098
Country	:	US
Telephone Number	:	615-920-7000
Fax Number	:	615-920-8775

Provider Business Practice Location Address
First Line	:	3170 BELMONT AVE
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44505
Country	:	US
Telephone Number	:	615-920-7000
Fax Number	:	615-920-8775

Authorized Official
Title or Position	:	REVENUE CYCLE MANAGER
Name	:	LISA BRADFORD
Credential	:
Telephone Number	:	931-308-5066

Provider Enumeration Date	:	11/26/2025
Last Update Date	:	12/01/2025

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