NPIMap

Organization Active NPI

Southeastern Psychiatric Management, Inc.

Doing business as GrandView Behavioral Health Center

  • Mental Health Counselor
  • Montgomery, AL
National Provider Identifier
1699839183
Registry record updated Mar 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
SOUTHEASTERN PSYCHIATRIC MANAGEMENT, INC.
Doing business as
GrandView Behavioral Health Center
Practice address
315 St. Lukes Drive
Montgomery, AL 36117-7109
Phone
(334) 409-9242
Fax
(334) 409-9186
NPI assigned
Dec 20, 2006
Last updated
Mar 12, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2008

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

Authorized official

Name
Ms. Joy R Ballenger
Title
Credentialing Network Manager
Phone
(256) 546-9265

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

315 St. Lukes Drive
Montgomery, AL 36117-7109

Mailing address

3001 Scenic Highway
Gadsden, AL 35904-3047
Phone (256) 546-9265

Other names 1

  • GrandView Behavioral Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050420000219 AL Part B Supplier - Clinic/Group Practice 5799743928 Receives reassigned benefits from 8 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gadsden, AL

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205280000000",
    "number": "1699839183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 SCENIC HIGHWAY",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359043047",
            "telephone_number": "256-546-9265",
            "fax_number": "256-549-0376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 ST. LUKES DRIVE",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361177109",
            "telephone_number": "334-409-9242",
            "fax_number": "334-409-9186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN PSYCHIATRIC MANAGEMENT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2008-03-12",
        "status": "A",
        "authorized_official_last_name": "BALLENGER",
        "authorized_official_first_name": "JOY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CREDENTIALING NETWORK MANAGER",
        "authorized_official_telephone_number": "256-546-9265",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GrandView Behavioral Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; 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.