Organization Active NPI

Advanced Behavioral Health Services, LLC

  • Community/Behavioral Health Agency
  • North Chesterfield, VA
National Provider Identifier
1780923292
Registry record updated Feb 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
0810004544 Issued in VA
Legal business name
ADVANCED BEHAVIORAL HEALTH SERVICES, LLC
Practice address
1241 Mall Dr
North Chesterfield, VA 23235-4879
Phone
(804) 539-2557
NPI assigned
Feb 4, 2013
Last updated
Feb 4, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2013

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

Authorized official

Name
Dr. Alan Thomas Von Kleiss, PSYDNPI 1790058899
Title
Ceo- Clinical Psychologist
Phone
(804) 539-2557

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 0810004544 VA Primary

Addresses

Primary practice location

1241 Mall Dr
North Chesterfield, VA 23235-4879

Mailing address

7514 Van Hoy Dr
North Chesterfield, VA 23235-6454
Phone (804) 539-2557

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130923000419 VA Part B Supplier - Clinic/Group Practice 4082858501 Receives reassigned benefits from 2 practitioners
Practice locations: North Chesterfield, VA

National Provider Directory

National Provider Directory

Locations

1215 Mall Dr
North Chesterfield, VA 23235
Phone (804) 539-2557

Practitioners & affiliated clinicians

Practitioners 6

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": "1359936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359936000000",
    "number": "1780923292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7514 VAN HOY DR",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232356454",
            "telephone_number": "804-539-2557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1241 MALL DR",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232354879",
            "telephone_number": "804-539-2557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED BEHAVIORAL HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-04",
        "last_updated": "2013-02-04",
        "status": "A",
        "authorized_official_last_name": "VON KLEISS",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "CEO- CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "804-539-2557",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "VA",
            "license": "0810004544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Chesterfield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2013; 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.