Provider Demographics
NPI:1821573023
Name:OCTAVE PSYCHIATRY BEHAVIORAL HEALTH PC
Entity type:Organization
Organization Name:OCTAVE PSYCHIATRY BEHAVIORAL HEALTH PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP REVENUE OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:KYM
Authorized Official - Middle Name:
Authorized Official - Last Name:EVERETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-504-2289
Mailing Address - Street 1:PO BOX 18397
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60055-8397
Mailing Address - Country:US
Mailing Address - Phone:415-360-3833
Mailing Address - Fax:628-234-3048
Practice Address - Street 1:45 E 20TH ST FL 6
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:415-360-3833
Practice Address - Fax:628-234-3048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-03
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty