| Integrated Behavioral Health, Inc. | |
|
600 Sun Temple Drive Madison AL 35758-5919 | |
| (256) 288-3333 | |
| (256) 288-3334 |
| Full Name | Integrated Behavioral Health, Inc. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 600 Sun Temple Drive, Madison, Alabama |
| Authorized Official Name and Position | Kelli Hardin (DIRECTOR OF CREDENTIALING) |
| Authorized Official Contact | 2562883333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Behavioral Health, Inc. 600 Sun Temple Drive Madison AL 35758-5919 Ph: (256) 288-3333 | Integrated Behavioral Health, Inc. 600 Sun Temple Drive Madison AL 35758-5919 Ph: (256) 288-3333 |
| NPI Number | 1730522699 |
|---|---|
| Provider Enumeration Date | 04/10/2013 |
| Last Update Date | 08/26/2019 |
| Medicare PECOS PAC ID | 7416194113 |
|---|---|
| Medicare Enrollment ID | O20130603000376 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730522699 | NPI | - | NPPES |
| Provider Name | Sanjay Malhotra |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023292596 PECOS PAC ID: 2567515968 Enrollment ID: I20120504000566 |
| Provider Name | Tina Jones-davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033478482 PECOS PAC ID: 2062676232 Enrollment ID: I20161104000306 |
| Provider Name | Bryant K Mahaffey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891014742 PECOS PAC ID: 8325283666 Enrollment ID: I20170316000653 |
| Provider Name | Yelena V Chistyakova |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295944056 PECOS PAC ID: 4183740558 Enrollment ID: I20171213001281 |
| Provider Name | Timothy Whalen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518911999 PECOS PAC ID: 6002827458 Enrollment ID: I20171213002243 |
| Provider Name | Jun Liu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184019903 PECOS PAC ID: 5395013429 Enrollment ID: I20190521001634 |
| Provider Name | Jasmine Jacobs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891204152 PECOS PAC ID: 8921363904 Enrollment ID: I20200511003237 |
| Provider Name | John C Hammond |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154766905 PECOS PAC ID: 9335389071 Enrollment ID: I20200512003083 |
| Provider Name | Ashley N Hanback |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962001636 PECOS PAC ID: 2668883901 Enrollment ID: I20210416001637 |
| Provider Name | Mallory E Avant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942953419 PECOS PAC ID: 4688068570 Enrollment ID: I20220217002358 |
| Provider Name | Brandy Nichole Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235697020 PECOS PAC ID: 1850632936 Enrollment ID: I20230509000258 |
| Provider Name | Kaitlyn Elizabeth Seybold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497538011 PECOS PAC ID: 5698120178 Enrollment ID: I20231228000824 |
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