NPIMap

Organization Active NPI

Tri-State Behavioral Health LLC

  • Psychiatry Physician
  • Boonville, IN
National Provider Identifier
1902073554
Registry record updated Apr 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
01048619A Issued in IN
Legal business name
TRI-STATE BEHAVIORAL HEALTH LLC
Practice address
1116 Millis Ave
St. Mary's Warrick
Boonville, IN 47601
Phone
(812) 962-2353
Fax
(812) 962-0915
NPI assigned
May 13, 2008
Last updated
Apr 11, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2013

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

Authorized official

Name
Dr. Anjum Shehzad Ashraf, M.D
Title
Member
Phone
(812) 962-2353

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 01048619A IN Primary

Addresses

Primary practice location

1116 Millis Ave
St. Mary's Warrick
Boonville, IN 47601

Mailing address

1900 Waters Ridge Dr
Newburgh, IN 47630-8084
Phone (812) 962-2353

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1210636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365638400000",
    "number": "1902073554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 WATERS RIDGE DR",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476308084",
            "telephone_number": "812-962-2353",
            "fax_number": "812-962-0915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1116 MILLIS AVE",
            "address_2": "ST. MARY'S WARRICK",
            "city": "BOONVILLE",
            "state": "IN",
            "postal_code": "47601",
            "telephone_number": "812-962-2353",
            "fax_number": "812-962-0915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-STATE BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-13",
        "last_updated": "2013-04-11",
        "status": "A",
        "authorized_official_last_name": "ASHRAF",
        "authorized_official_first_name": "ANJUM",
        "authorized_official_middle_name": "SHEHZAD",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "812-962-2353",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01048619A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boonville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2013; 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.