NPIMap

Organization Active NPI

Warren Behavioral Care, Inc

  • Clinical Psychologist
  • Troy, AL
National Provider Identifier
1043418098
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1357 Issued in AL
Legal business name
WARREN BEHAVIORAL CARE, INC
Practice address
889 Elba Hwy
Troy, AL 36079-6017
Phone
(334) 808-8991
Fax
(334) 808-8995
NPI assigned
Jul 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Dr. Fernelle Lekoyne Warren, PH.D.NPI 1023058161
Title
Licensed Psychologist
Phone
(334) 808-8991

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X 1357 AL Primary
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X PSY003090 GA

Addresses

Primary practice location

889 Elba Hwy
Troy, AL 36079-6017

Mailing address

PO Box 952
Troy, AL 36081-0952
Phone (334) 808-8991

Other identifiers 1

IdentifierTypeStateIssuer
61-00470OtherALUNITED HEALTHCARE SERVICE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060227000580 AL Part B Supplier - Clinic/Group Practice 2668488750 Receives reassigned benefits from 2 practitioners
Practice locations: Troy, AL

National Provider Directory

National Provider Directory
Tax ID family
Warren Behavioral Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 12

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": "1184025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1043418098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 952",
            "city": "TROY",
            "state": "AL",
            "postal_code": "360810952",
            "telephone_number": "334-808-8991",
            "fax_number": "334-808-8995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "889 ELBA HWY",
            "city": "TROY",
            "state": "AL",
            "postal_code": "360796017",
            "telephone_number": "334-808-8991",
            "fax_number": "334-808-8995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARREN BEHAVIORAL CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-10",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "WARREN",
        "authorized_official_first_name": "FERNELLE",
        "authorized_official_middle_name": "LEKOYNE",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "334-808-8991",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "AL",
            "license": "1357",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY003090",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE SERVICE",
            "identifier": "61-00470",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.