Northridge Behavioral Health PLLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

NORTHRIDGE BEHAVIORAL HEALTH PLLC

Doing business as

Northridge Behavioral Health PLLC

Practice address

2829 Babcock Rd Ste 126
San Antonio, TX 78229-6009

Phone

(440) 681-0575

NPI assigned

Mar 7, 2019

Organization subpart

No

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

Authorized official

Name

Ijeoma C Ajufo, MDNPI 1902216427

Title

Owner/MD

Phone

(440) 681-0575

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Northridge Behavioral Health PLLC Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ijeoma Ajufo, MD

  • Psychiatry Physician
  • San Antonio, TX
  • NPI 1902216427
  Medicare reassignment NPD Authorized official
• Monique Lynette Carroll, PA-C

  • Physician Assistant
  • San Antonio, TX
  • NPI 1679968770
  Medicare reassignment
• Anthony Ikenna Okafor

  • Physician Assistant
  • San Antonio, TX
  • NPI 1417477613
  NPD

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

{
    "created_epoch": "1551916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556582400000",
    "number": "1144788258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2829 BABCOCK RD STE 126",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782296009",
            "telephone_number": "440-681-0575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2829 BABCOCK RD STE 126",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782296009",
            "telephone_number": "440-681-0575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHRIDGE BEHAVIORAL HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-07",
        "last_updated": "2019-04-30",
        "status": "A",
        "authorized_official_last_name": "AJUFO",
        "authorized_official_first_name": "IJEOMA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER/MD",
        "authorized_official_telephone_number": "440-681-0575",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3856486-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northridge Behavioral Health PLLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Northridge Behavioral Health PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Michael S. Northrop, M.D.
• Northrup Counseling
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• Jason Northrup, PH.D., LMFT-S
• Kirsten Charlotte Northrup, M.M.F.T, LPC, LMFT

• Psychiatry Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2019; 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.