Provider Demographics
NPI:1295219194
Name:BIRCHWOOD PROFESSIONAL LLC
Entity Type:Organization
Organization Name:BIRCHWOOD PROFESSIONAL LLC
Other - Org Name:AWAKEN TELEPSYCHIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCARTNEY
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:724-877-1257
Mailing Address - Street 1:1299 HALL AVE
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146
Mailing Address - Country:US
Mailing Address - Phone:724-866-7184
Mailing Address - Fax:
Practice Address - Street 1:1299 HALL AVE
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:PA
Practice Address - Zip Code:16146
Practice Address - Country:US
Practice Address - Phone:724-866-7184
Practice Address - Fax:979-230-1029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-18
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty