NPIMap

Organization Active NPI

Behavioral Connections of Wood County

  • Clinical Social Worker
  • Bowling Green, OH
National Provider Identifier
1700064870
Registry record updated Jan 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
S28711 Issued in OH
Legal business name
BEHAVIORAL CONNECTIONS OF WOOD COUNTY
Practice address
320 W Gypsy Lane Rd
Bowling Green, OH 43402-4572
Phone
(419) 352-5387
NPI assigned
Jan 31, 2008
Last updated
Jan 31, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2008

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

Authorized official

Name
Dr. Richard Goldberg, PH.D.
Title
Chief Executive Officer
Phone
(419) 352-5387

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X S28711 OH Primary

Addresses

Primary practice location

320 W Gypsy Lane Rd
Bowling Green, OH 43402-4572

Mailing address

320 W Gypsy Lane Rd
Bowling Green, OH 43402-4572
Phone (419) 352-5387

Other identifiers 1

IdentifierTypeStateIssuer
29968067400OtherOHOHIO BWC

National Provider Directory

National Provider Directory
Tax ID family
Behavioral Connections of Wood County Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 5

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": "1201737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201737600000",
    "number": "1700064870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 W GYPSY LANE RD",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434024572",
            "telephone_number": "419-352-5387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 W GYPSY LANE RD",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434024572",
            "telephone_number": "419-352-5387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEHAVIORAL CONNECTIONS OF WOOD COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-31",
        "last_updated": "2008-01-31",
        "status": "A",
        "authorized_official_last_name": "GOLDBERG",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "419-352-5387",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S28711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO BWC",
            "identifier": "29968067400",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2008; 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.