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PROVIDENCE HEALTH SERVICES
NPI 1396012837
Psychiatry & Neurology - Addiction Medicine in Washington, DC

Active since November 29, 2011
1053 BUCHANAN ST NE, SUITE 055, WASHINGTON, DC 20017(202) 269-7626(202) 269-7616 Get Directions Write a Review

NPPES record last updated: September 6, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Providence Health Services NPPES

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

PROVIDENCE HEALTH SERVICES (NPI 1396012837) is a healthcare organization registered as an addiction medicine in Washington, District Of Columbia and active in the NPI registry since November 2011. The organization lists Charles F Haberkern, Vp, as its authorized official.

NPPES Registry Identity

NPI1396012837
Entity TypeOrganization
Primary Taxonomy2084A0401X
Legal Business NamePHS BEHAVIORAL MEDICINE
Location Address1053 BUCHANAN ST NE, SUITE 055Washington, DC 20017-2712
Mailing Address1150 Varnum St Ne, St Catherine's Hall, Room 102Washington, DC 20017-2104 · (202) 854-4069 · Fax (202) 854-7825
Phone(202) 269-7626
Fax(202) 269-7616
Organization SubpartYesParent: Providence Hospital
Authorized OfficialCharles F HaberkernVp · (202) 854-4255
Enumeration DateNovember 29, 2011
Last NPPES UpdateSeptember 6, 2016
✔ NPI 1396012837 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPsychiatry & Neurology · Addiction MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2084A0401X
License✔ Licensed in DC · HFD01-0212
Definition
A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine
Also ListedPsychiatry & Neurology · NeurologyTaxonomy 2084N0400X · License HFD01-0212 (DC)
Also ListedGeneral Acute Care HospitalTaxonomy 282N00000X · License HFD01-0112 (DC)
1053 BUCHANAN ST NE, Washington, DC 20017
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Other Names 1

Other NameProvidence Health Services

Other Identifiers 4

Medicaid09810714VA
Medicare PIN090006
Medicaid029833400DC
Medicaid005145400MD

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. JADE N. NAYLOR PA-C
Physician Assistant
1053 BUCHANAN ST NE, PROVIDENCE HOSPITAL BEHAVIORAL HEALTH OPC-SETON HOUSE
WASHINGTON, DC 20017
District of Columbia (301) 363-2575
RAQUEL W GORDON PH.D.
Psychologist
1053 BUCHANAN ST NE
WASHINGTON, DC 20017
District of Columbia (202) 854-4889

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 Phs Behavioral Medicine's NPI number?

The NPI number for Phs Behavioral Medicine is 1396012837. It was assigned to this organization in the NPPES registry on November 29, 2011. The provider is also known as Providence Health Services.

Where is Phs Behavioral Medicine located?

Phs Behavioral Medicine is located at 1053 Buchanan St NE Suite 055, Washington, DC 20017. The listed phone number is (202) 269-7626.

What is Phs Behavioral Medicine's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Addiction Medicine, with taxonomy code 2084A0401X.

When was this NPI record last updated?

The NPPES record for Phs Behavioral Medicine was last updated on September 6, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.