Nova Behavioral Health, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

NOVA BEHAVIORAL HEALTH, LLC

Practice address

703 S Elmer Ave Ste 107
Sayre, PA 18840-2400

Phone

(570) 203-1735

Fax

(570) 888-2641

NPI assigned

Apr 27, 2021

Last updated

Aug 26, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nadya Gifeisman, LCSWNPI 1104240704

Title

Therapist

Phone

(174) 026-2377

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

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.

• Nadya Gifeisman

  • Clinical Social Worker
  • Sayre, PA
  • NPI 1104240704
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1619481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629936000000",
    "number": "1316529415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 QUEEN ESTHER DR",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188409698",
            "telephone_number": "740-262-3777",
            "fax_number": "570-888-2641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 S ELMER AVE STE 107",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188402400",
            "telephone_number": "570-203-1735",
            "fax_number": "570-888-2641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-27",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A",
        "authorized_official_last_name": "GIFEISMAN",
        "authorized_official_first_name": "NADYA",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "174-026-2377",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Marie Nobles
• Heather Sue Norman, M.D.
• Matthew Ryan Norris, MD
• Brooke Lynn Norton, AGNP-C
• Kim J. Norville, M.D.
• Angella Novotny
• Joan Elizabeth O'Connor, CRNP
• Peter O'Halloran, MD
• Kristyn O'Rourke, LCSW, CAADC
• Esther M Oakley, M.D.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Sayre, PA
• Providers in Sayre, PA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; 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.