Bethel Psychiatric Services PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

BETHEL PSYCHIATRIC SERVICES PLLC

Practice address

5062 S Espana CT
Centennial, CO 80015-5805

Phone

(303) 766-5074

Fax

(303) 766-8374

NPI assigned

Jan 9, 2013

Organization subpart

Yes

Parent organization

BETHEL PSYCHIATRIC SERVICES PLLCAs reported in NPPES

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

Authorized official

Name

Ajibade Adeladan, MD

Title

Owner

Phone

(646) 542-9385

Specialties & licenses 1

Addresses

Part of

Bethel Psychiatric Services

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

{
    "created_epoch": "1357689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357689600000",
    "number": "1174860282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5062 S ESPANA CT",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "800155805",
            "telephone_number": "646-542-9385",
            "fax_number": "303-766-8374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5062 S ESPANA CT",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "800155805",
            "telephone_number": "303-766-5074",
            "fax_number": "303-766-8374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHEL PSYCHIATRIC SERVICES PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BETHEL PSYCHIATRIC SERVICES PLLC",
        "enumeration_date": "2013-01-09",
        "last_updated": "2013-01-09",
        "status": "A",
        "authorized_official_last_name": "ADELADAN",
        "authorized_official_first_name": "AJIBADE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "646-542-9385",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Centennial, CO
• Providers in Centennial, CO by specialty
• Clinical Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2013; 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.