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Contact Information

SOUTHSIDE BEHAVIORAL HEALTH
143 INDUSTRIAL PARKWAY
CLARKSVILLE, VA23927
 Phone: 434-572-6916
 Fax: 434-374-3321
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Behavioral Health

251S00000X
 

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Mental Health

101YM0800X
 

Psychiatry

2084P0800X 26 Physician/Psychiatry
Indicates primary specialty

NPI Profile & details for SOUTHSIDE BEHAVIORAL HEALTH

NPI Number 1700890761
LBN Legal business name SOUTHSIDE BEHAVIORAL HEALTH
Authorized official ELIZABETH ENGELHORN - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 07/27/2006
Last updated 03/09/2021 - About 5 years ago
Identifiers
VA License # 090
VA Medicaid 004945514
VA Medicaid 1700890761
VA Medicaid 1912252958
VA Other CC3355 MEDICARE RAILROAD
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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