NPIMap

Organization Active NPI

Lives Savers Behavioral Health LLC

Doing business as Lives Savers Behavioral Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Purcellville, VA
National Provider Identifier
1275395188
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
LIVES SAVERS BEHAVIORAL HEALTH LLC
Doing business as
Lives Savers Behavioral Health
Practice address
102 N 21St St # 220
Purcellville, VA 20132-5606
Phone
(240) 415-0064
Fax
(240) 415-0209
NPI assigned
Jan 25, 2024
Organization subpart
Yes
Parent organization
-As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Authorized official

Name
Dr. Oluwakemi Osidele, DNP, PMHNP-BCNPI 1649649468
Title
President
Phone
(240) 575-9940

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
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

102 N 21St St # 220
Purcellville, VA 20132-5606

Mailing address

211 S Jefferson St Ste 201
Frederick, MD 21701-7012
Phone (240) 415-0064

Other names 1

  • Lives Savers Behavioral Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240321001178 VA Part B Supplier - Clinic/Group Practice 9638530249 Receives reassigned benefits from 1 practitioner
Practice locations: Purcellville, VA

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
Lives Savers Behav HLTH LLC

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1706140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706572800000",
    "number": "1275395188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 S JEFFERSON ST STE 201",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217017012",
            "telephone_number": "240-415-0064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 N 21ST ST # 220",
            "city": "PURCELLVILLE",
            "state": "VA",
            "postal_code": "201325606",
            "telephone_number": "240-415-0064",
            "fax_number": "240-415-0209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVES SAVERS BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "-",
        "enumeration_date": "2024-01-25",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A",
        "authorized_official_last_name": "OSIDELE",
        "authorized_official_first_name": "OLUWAKEMI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "240-575-9940",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lives Savers Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lives Savers Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Purcellville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; 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.