KETAMINE TREATMENT CENTERS OF PRINCETON, LLC (NPI# 1538705835) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538705835 |
| Entity Type | Organization |
| Organization Name | KETAMINE TREATMENT CENTERS OF PRINCETON, LLC |
| Practice Address |
357 S Gulph Rd Ste 260 King of Prussia PA 19406-3174 |
| Mailing Address |
800 Bunn Dr Ste 304 Princeton NJ 08540-1968 |
| Practice Telephone | 8885668774 |
| Mailing Telephone | 8885668774 |
| Enumeration Date | 2019-11-21 |
| Last Update Date | 2019-11-21 |
| Authorized Official Name | STEVEN P. LEVINE (MANAGING MEMBER) |
| Authorized Official Telephone | 6096514429 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | KETAMINE TREATMENT CENTERS OF PRINCETON, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Actify Neurotherapies | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679119994 | Ketamine Treatment Centers of Princeton, LLC | Psychiatry & Neurology | 9800 Falls Rd Ste 105, Potomac, MD 20854-3939 | 2019-11-21 |
| 1730725052 | Ketamine Treatment Centers of Princeton, LLC | Psychiatry & Neurology | 91 S Jefferson Rd Ste 301, Whippany, NJ 07981-1037 | 2019-11-21 |
| 1174169478 | Ketamine Treatment Centers of Princeton, LLC | Psychiatry & Neurology | 1122 Kenilworth Dr Ste 418, Towson, MD 21204-2148 | 2019-11-21 |
| 1114563434 | Ketamine Treatment Centers of Princeton, LLC | Psychiatry & Neurology | 1411 N Flagler Dr Ste 4700, West Palm Beach, FL 33401-3408 | 2019-11-21 |
| 1780174482 | Ketamine Treatment Centers of Princeton, LLC | Psychiatry & Neurology | 12 E 44th St Fl 6, New York, NY 10017-3624 | 2018-05-17 |
| 1609288604 | Ketamine Treatment Centers of Princeton, LLC | Psychiatry & Neurology | 800 Bunn Dr, Suite 304, Princeton, NJ 08540-1968 | 2014-05-24 |
| Street Address |
357 S GULPH RD STE 260 |
| City | KING OF PRUSSIA |
| State | PA |
| Zip Code | 19406-3174 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346887296 | Optical World Nj Corp | Optometrist | Optical World, 160 N. Gulph Rd King of Prussia Plaza Suite #2377, King of Prussia, PA 19406 | 2019-12-10 |
| 1194213694 | Compass Recovery Center | Clinic/Center | 901 E 8th Ave Ste 203, King of Prussia, PA 19406 | 2018-04-30 |
| 1154858520 | Recovery Centers of America At Ventnor Nj Medicaid Only | Clinic/Center | 2701 Renaissance Boulevard, 4th Floor, King of Prussia, PA 19406 | 2017-05-17 |
| 1568913192 | Luke Gillespie | Counselor | 680 American Avenue, Suite 320, King of Prussia, PA 19406 | 2016-10-19 |
| 1932652906 | Bayada Home Health Care, Inc. | Home Health | 700 American Ave Ste 103, King of Prussia, PA 19406 | 2016-07-26 |
| 1912357690 | Barsha Moktan | Dentist | 357 S Gulph Road, #110, King of Prussia, PA 19406 | 2016-06-14 |
| 1588057756 | National Counseling Group, Inc | Counselor | 1150 1st Avenue, #501, King of Prussia, PA 19406 | 2015-03-12 |
| 1184020174 | Dr. Jeanvickey Lusk, M.d. & Co. P.C. | Family Medicine | 315 Gypsy Lane, King of Prussia, PA 19406 | 2014-11-18 |
| 1912303033 | Masuma Bahora | Obstetrics & Gynecology | 210 Mall Blvd Ste 220, King of Prussia, PA 19406 | 2014-11-17 |
| 1942612486 | Delphi Medical Group | Durable Medical Equipment & Medical Supplies | 1600 First Avenue Ste 400, King of Prussia, PA 19406 | 2014-06-02 |
| Find all providers in zip 19406 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962981167 | Keystone Neurocare LLC | Psychiatry & Neurology | 1000 1st Ave Ste 100, King of Prussia, PA 19406-1333 | 2018-08-08 |
| 1689968570 | Roman Roytman | Psychiatry & Neurology | 210 Mall Blvd Ste 204, King of Prussia, PA 19406-3260 | 2011-06-08 |
| 1174683270 | Naomi Asnien Parish | Psychiatry & Neurology | 184 Redwood Rd, King of Prussia, PA 19406-1924 | 2006-12-11 |
| 1144318064 | David Anthony Scola | Psychiatry & Neurology | 179 Hughes Rd, King of Prussia, PA 19406-3709 | 2006-10-10 |
| 1952550030 | Alan Lipschitz | Psychiatry & Neurology | 2301 Renaissance Blvd, Rn0320, King of Prussia, PA 19406-2772 | 2008-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285235663 | Doreen Thomas-payne | Psychiatry & Neurology | 422 Pheasant Ln, Lafayette Hill, PA 19444-1204 | 2020-11-03 |
| 1558961698 | Bierkortte Psychiatric Pllc | Psychiatry & Neurology | 1001 E Elfinwild Rd, Allison Park, PA 15101-3912 | 2020-10-28 |
| 1265031603 | Center for Integrative Psychiatry and Neuromodulation, Plc | Psychiatry & Neurology | 822 Montgomery Ave Ste 208, Narberth, PA 19072-1946 | 2020-10-17 |
| 1518576602 | Kathleen A Lyon, Md PC | Psychiatry & Neurology | 201 Water St Ste 1, Milford, PA 18337-1247 | 2020-07-24 |
| 1588272595 | Ade & Mo LLC | Psychiatry & Neurology | 589 Bethlehem Pike Ste 200, Montgomeryville, PA 18936-9744 | 2020-07-15 |
| 1962029306 | Ara Dadivanyan | Psychiatry & Neurology | 201 Reeceville Rd., Brandywine Hospital, Coatesville, PA 19320 | 2020-07-01 |
| 1669098919 | Sara Mostafa | Psychiatry & Neurology | Brandy Wine Hospital, 201 Reeceville Rd, Coatesville, PA 19320 | 2020-06-23 |
| 1205452760 | Xaler LLC | Psychiatry & Neurology | 4379 Easton Ave # 110, Bethlehem, PA 18020-1483 | 2020-06-22 |
| 1366067464 | Hgmd LLC | Psychiatry & Neurology | 3216 Hemlock Farms, Hawley, PA 18428-9113 | 2020-06-15 |
| 1356964506 | Timothy Robert Derosa | Psychiatry & Neurology | Brandywine Hospital 201 Reeceville Rd., Coatesville, Pa, PA 19320 | 2020-05-22 |
| Find all providers with the same taxonomy | ||||
| City | KING OF PRUSSIA |
| Zip Code | 19406 |
Please comment or provide details below to improve the information on KETAMINE TREATMENT CENTERS OF PRINCETON, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.