NPIMap

Organization Active NPI

Customized Behavioral Healthcare

  • Clinical Psychologist
  • Columbus, OH
National Provider Identifier
1033860283
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
CUSTOMIZED BEHAVIORAL HEALTHCARE
Practice address
3244 Henderson Rd Ste 4
Columbus, OH 43220-7300
Phone
(614) 664-3175
Fax
(614) 386-1692
NPI assigned
Jan 10, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Anthony Lamont Rivers, PSY.D.
Title
Owner
Phone
(614) 664-3175

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

3244 Henderson Rd Ste 4
Columbus, OH 43220-7300

Mailing address

3244 Henderson Rd Ste 4
Columbus, OH 43220-7300
Phone (614) 664-3175

Other names 1

  • Customized Behavioral Healthcare Doing business as

National Provider Directory

National Provider Directory

Locations

3244 Henderson Rd
Ste 4
Columbus, OH 43220
Phone (614) 664-3175

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1641772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690502400000",
    "number": "1033860283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3244 HENDERSON RD STE 4",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432207300",
            "telephone_number": "614-664-3175",
            "fax_number": "614-386-1692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3244 HENDERSON RD STE 4",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432207300",
            "telephone_number": "614-664-3175",
            "fax_number": "614-386-1692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOMIZED BEHAVIORAL HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-10",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A",
        "authorized_official_last_name": "RIVERS",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "LAMONT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-664-3175",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Customized Behavioral Healthcare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Customized Behavioral Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.