SOUTHWESTERN OHIO BEHAVIORAL HEALTH,LLC
NPI 1376631713
Psychologist - Clinical in Centerville, OH

Q: What is Southwestern Ohio Behavioral Health,llc's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Active since October 11, 2006

35 IRONGATE PARK DR, CENTERVILLE, OH 45459(937) 435-8864(937) 435-8264 Get Directions Write a Review

NPPES record last updated: June 29, 2011. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Southwestern Ohio Behavioral Health,llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHWESTERN OHIO BEHAVIORAL HEALTH,LLC (NPI 1376631713) is a healthcare organization registered as a clinical in Centerville, Ohio and active in the NPI registry since October 2006. The organization lists Kimberly Shaffer Tate, Owner-clinical Psychologist, as its authorized official.

NPPES Registry Identity

NPI1376631713

Entity TypeOrganization

Primary Taxonomy103TC0700X

Legal Business NameSOUTHWESTERN OHIO BEHAVIORAL HEALTH,LLC

Location Address35 IRONGATE PARK DRCenterville, OH 45459-4616

Mailing AddressPo Box 41158Dayton, OH 45441-0158 · (937) 435-8864 · Fax (937) 435-8264

Phone(937) 435-8864

Fax(937) 435-8264

Organization SubpartNo

Authorized OfficialKimberly Shaffer TateOwner-clinical Psychologist · (937) 435-8864

Enumeration DateOctober 11, 2006

Last NPPES UpdateJune 29, 2011

✔ NPI 1376631713 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in OH · 4664

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

35 IRONGATE PARK DR, Centerville, OH 45459

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Other Identifiers 1

Medicare PINSO9351261OH

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Southwestern Ohio Behavioral Health,llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Southwestern Ohio Behavioral Health,llc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Kimberly Tate, PSY.D.

Clinical Psychologist

NPI 1154418903

35 IRON GATE PARK DR.
Centerville, OH 45459

(937) 435-8864

✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southwestern Ohio Behavioral Health,llc's NPI number?

The NPI number for Southwestern Ohio Behavioral Health,llc is 1376631713. It was assigned to this organization in the NPPES registry on October 11, 2006.

Where is Southwestern Ohio Behavioral Health,llc located?

Southwestern Ohio Behavioral Health,llc is located at 35 Irongate Park Dr, Centerville, OH 45459. The listed phone number is (937) 435-8864.

What is Southwestern Ohio Behavioral Health,llc's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Southwestern Ohio Behavioral Health,llc enrolled in Medicare?

Yes. Southwestern Ohio Behavioral Health,llc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Southwestern Ohio Behavioral Health,llc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Southwestern Ohio Behavioral Health,llc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Southwestern Ohio Behavioral Health,llc was last updated on June 29, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.