Innovative Behavioral Medicine LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

INNOVATIVE BEHAVIORAL MEDICINE LLC

Doing business as

Innovative Behavioral Medicine LLC

Practice address

201 Penn Center Blvd Ste 457
Pittsburgh, PA 15235-5435

Phone

(412) 439-1251

Fax

(412) 291-3003

NPI assigned

Jul 13, 2019

Organization subpart

No

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

Authorized official

Name

Christopher J Goisse, MBA

Title

Cfo

Phone

(724) 984-8645

Specialties & licenses 2

Addresses

Other names 1

• Innovative Behavioral Medicine LLC Doing business as

Locations

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

{
    "created_epoch": "1562976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562976000000",
    "number": "1093367633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PENN CENTER BLVD STE 457",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152355435",
            "telephone_number": "412-439-1251",
            "fax_number": "412-291-3003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 PENN CENTER BLVD STE 457",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152355435",
            "telephone_number": "412-439-1251",
            "fax_number": "412-291-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE BEHAVIORAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-13",
        "last_updated": "2019-07-13",
        "status": "A",
        "authorized_official_last_name": "GOISSE",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "724-984-8645",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Innovative Behavioral Medicine LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Providers in Pittsburgh, PA by specialty
• Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2019; 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.