Provider Demographics
NPI:1255512109
Name:AAA, STRESS, ANXIETY & ADHD CENTER, LLC
Entity type:Organization
Organization Name:AAA, STRESS, ANXIETY & ADHD CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SAHAJA
Authorized Official - Middle Name:
Authorized Official - Last Name:REDDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-690-8901
Mailing Address - Street 1:2739 NAVARRE AVE
Mailing Address - Street 2:UNIT C:302
Mailing Address - City:OREGON
Mailing Address - State:OH
Mailing Address - Zip Code:43616-8200
Mailing Address - Country:US
Mailing Address - Phone:419-690-8901
Mailing Address - Fax:419-690-8906
Practice Address - Street 1:2739 NAVARRE AVE
Practice Address - Street 2:UNIT C:302
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-8200
Practice Address - Country:US
Practice Address - Phone:419-690-8901
Practice Address - Fax:419-690-8906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35083625R2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHJV9345141OtherMEDICARE GROUP #