Provider Demographics
NPI:1679256069
Name:CSW BEHAVORIAL HEALTH AND MEDICAL SERVICES
Entity type:Organization
Organization Name:CSW BEHAVORIAL HEALTH AND MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:JOINT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:OKEKE
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, MSN ,NP
Authorized Official - Phone:571-277-0841
Mailing Address - Street 1:710 VARNUM ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-7230
Mailing Address - Country:US
Mailing Address - Phone:571-277-0841
Mailing Address - Fax:
Practice Address - Street 1:710 VARNUM ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-7230
Practice Address - Country:US
Practice Address - Phone:571-277-0841
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty