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Organization
MOMENTUM BEHAVIORAL HEALTH GROUP LLC
Active
Organization
MOMENTUM BEHAVIORAL HEALTH GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRSTEN BAILEY DERICKS PA-C (PROVIDER)
(812) 221-1186
Entity
Organization
Contact information
Practice address
3211 GRANT LINE RD STE 15, NEW ALBANY, IN 47150-2175
(812) 221-1186
(949) 882-0452
Mailing address
4510 CHARLESTOWN RD, PMB #110, NEW ALBANY, IN 47150-8513
(812) 221-1186
(949) 882-0452
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/07/2026
Last updated
02/11/2026
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