NPIMap

Organization Active NPI

Sweetwater Behavioral Health and Wellness, PC

  • Psychiatry Physician
  • Ambridge, PA
National Provider Identifier
1942775853
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
SWEETWATER BEHAVIORAL HEALTH AND WELLNESS, PC
Practice address
22 Beaver St
Ambridge, PA 15003-2487
Phone
(412) 347-1978
NPI assigned
Oct 6, 2018
Last updated
Jul 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Authorized official

Name
Wynne Lundblad, MDNPI 1205198199
Title
President
Phone
(412) 347-1978

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

22 Beaver St
Ambridge, PA 15003-2487

Mailing address

618 Beaver St Ste 200
Sewickley, PA 15143-1906
Phone (412) 347-1978

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191029000985 PA Part B Supplier - Clinic/Group Practice 8628300449 Receives reassigned benefits from 5 practitioners
Practice locations: Ambridge, PA

National Provider Directory

National Provider Directory

Locations

22 Beaver St
Ambridge, PA 15003
Phone (412) 347-1978

618 Beaver St
Ste 200
Sewickley, PA 15143
Phone (412) 347-1978

Practitioners & affiliated clinicians

Practitioners 9

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": "1538784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690416000000",
    "number": "1942775853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 BEAVER ST STE 200",
            "city": "SEWICKLEY",
            "state": "PA",
            "postal_code": "151431906",
            "telephone_number": "412-347-1978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 BEAVER ST",
            "city": "AMBRIDGE",
            "state": "PA",
            "postal_code": "150032487",
            "telephone_number": "412-347-1978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWEETWATER BEHAVIORAL HEALTH AND WELLNESS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-06",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A",
        "authorized_official_last_name": "LUNDBLAD",
        "authorized_official_first_name": "WYNNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "412-347-1978",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ambridge, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; 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.