NPIMap

Organization Active NPI

Excelsis Behavioral Health, Inc.

  • Social Worker
  • Tampa, FL
National Provider Identifier
1063897262
Registry record updated Jul 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Legal business name
EXCELSIS BEHAVIORAL HEALTH, INC.
Practice address
4144 N Armenia Ave
Suite 350
Tampa, FL 33607-6400
Phone
(855) 743-4273
Fax
(855) 743-4273
NPI assigned
Jul 29, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2015

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

Authorized official

Name
Thomas George Economos, LCSW
Title
Ceo
Phone
(855) 473-4273

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X
Addiction (Substance Use Disorder) PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TA0400X
Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 104100000X Primary

Addresses

Primary practice location

4144 N Armenia Ave
Suite 350
Tampa, FL 33607-6400

Mailing address

4144 N Armenia Ave
Suite 350
Tampa, FL 33607-6400
Phone (855) 743-4273

Other identifiers 1

IdentifierTypeStateIssuer
P1400008092OtherFLBEHAVIORAL HEATH CARE COMPANY

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1438128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438128000000",
    "number": "1063897262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4144 N ARMENIA AVE",
            "address_2": "SUITE 350",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076400",
            "telephone_number": "855-743-4273",
            "fax_number": "855-743-4273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4144 N ARMENIA AVE",
            "address_2": "SUITE 350",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076400",
            "telephone_number": "855-743-4273",
            "fax_number": "855-743-4273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELSIS BEHAVIORAL HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-29",
        "last_updated": "2015-07-29",
        "status": "A",
        "authorized_official_last_name": "ECONOMOS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "855-473-4273",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEHAVIORAL HEATH CARE COMPANY",
            "identifier": "P1400008092",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2015; 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.