| Licking Memorial Behavioral Health | |
|
200 Messimer Dr Newark OH 43055-3627 | |
| (740) 348-4870 | |
| (740) 348-4871 |
| Full Name | Licking Memorial Behavioral Health |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 200 Messimer Dr, Newark, Ohio |
| Authorized Official Name and Position | Robert A. Montagnese (EXECUTIVE VICE PRESIDENT) |
| Authorized Official Contact | 7403484000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Licking Memorial Behavioral Health 200 Messimer Dr Newark OH 43055-3627 Ph: (740) 348-4870 | Licking Memorial Behavioral Health 200 Messimer Dr Newark OH 43055-3627 Ph: (740) 348-4870 |
| NPI Number | 1932149150 |
|---|---|
| Provider Enumeration Date | 06/07/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932149150 | NPI | - | NPPES |
| 0118992 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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