Eagle Behavioral Health Services

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

EAGLE BEHAVIORAL HEALTH SERVICES

Practice address

1007 N Front St Ste 2S
Harrisburg, PA 17102-3320

Phone

(717) 973-1108

Fax

(717) 674-7696

NPI assigned

Jun 30, 2021

Organization subpart

No

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

Authorized official

Name

Theresa N Adigwu, CRNPNPI 1881164358

Title

Owner of Entity

Phone

(717) 973-1108

Specialties & licenses 1

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.

• Theresa Ngozi Adigwu, CRNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Harrisburg, PA
  • NPI 1881164358
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632096000000",
    "number": "1356911465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 N FRONT ST STE 2S",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171023320",
            "telephone_number": "717-973-1108",
            "fax_number": "717-674-7696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 N FRONT ST STE 2S",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171023320",
            "telephone_number": "717-973-1108",
            "fax_number": "717-674-7696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE BEHAVIORAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-30",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A",
        "authorized_official_last_name": "ADIGWU",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER OF ENTITY",
        "authorized_official_telephone_number": "717-973-1108",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Dutka
• Andrew Philip Duty, B.A.
• Kathleen Marie Dwyer, RD, LDN, PHD
• Ellen M Dyer, CRNP
• Dynamic Rehab Solutions
• Jan Early, LPN
• Earth Angels Healthcare Services LLC.
• James W Eash, MSW
• Melinda Margaret Eash, MS
• East End Medical Group

• Psychiatric/Mental Health Nurse Practitioner in Harrisburg, PA
• Providers in Harrisburg, PA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.