MOUNTAIN STATES HEALTH ALLIANCE OUT-PATIENT BEHAVIORAL HEALTH (NPI# 1083936033) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083936033 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN STATES HEALTH ALLIANCE OUT-PATIENT BEHAVIORAL HEALTH |
| Practice Address |
2012 Brookside Dr Kingsport TN 37660-4645 |
| Mailing Address |
1021 W Oakland Ave Suite 207 Johnson City TN 37604-2191 |
| Practice Telephone | 4238575566 |
| Practice Fax Number | 4238575564 |
| Mailing Telephone | 4239523104 |
| Mailing Fax Number | 4239523109 |
| Enumeration Date | 2010-02-18 |
| Last Update Date | 2010-02-18 |
| Authorized Official Name | GRACIELA PEREIRA (AVP BEHAVIORAL HEALTH AND REHAB SER) |
| Authorized Official Telephone | 4239521701 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TH0100X |
Psychologist Specialization: Health Service |
Behavioral Health & Social Service Providers |
| Street Address |
2012 BROOKSIDE DR |
| City | KINGSPORT |
| State | TN |
| Zip Code | 37660-4645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366437154 | Joe Howard Owens | Podiatrist | 2012 Brookside Dr, Suite 9, Kingsport, TN 37660-4645 | 2005-09-17 |
| 1912178112 | Kingsport Plastic Surgery, PC | Surgery | 2012 Brookside Dr, Suite 1, Kingsport, TN 37660-4645 | 2008-03-14 |
| 1053479139 | Lesley Ann Jones | Family Medicine | 2012 Brookside Dr, Ste 6, Kingsport, TN 37660-4645 | 2006-12-04 |
| 1639190846 | Blue Ridge Neurology Associates P.C. | Specialist | 2012 Brookside Dr, Ste. 8, Kingsport, TN 37660-4645 | 2006-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750909891 | Nancy Gober | Pharmacist | Holston Valley Medical Center Inpatient Pharmacy, 130 W Ravine, Kingsport, TN 37660 | 2020-07-06 |
| 1700437621 | Tammy Denise Leblanc | Technician | 125 Lancer Rd, Kingsport, TN 37660 | 2019-09-23 |
| 1831743392 | Independent Physical Therapy | Occupational Therapist | 1704 E. Stone Dr. Ste 120, Kingsport, TN 37660 | 2019-08-01 |
| 1871095315 | Macie Anderson | Nurse Practitioner | 411 Clay St, Kingsport, TN 37660 | 2018-03-01 |
| 1053813527 | Pulitzer Orthodontics, LLC | Dentist | 1200 Pulitzer Place, Kingsport, TN 37660 | 2018-03-01 |
| 1174038749 | Sbh-kingsport | Psychiatric Hospital | 1025 Executive Park Blvd, Kingsport, TN 37660 | 2017-12-05 |
| 1548771447 | Sara B Ball | Registered Nurse | 111 W Stone Dr Ste 240, Kingsport, TN 37660 | 2017-10-18 |
| 1821525361 | Ashley Brook Weems | Nurse Practitioner | Six Sheridan Square Suite 100, Kingsport, TN 37660 | 2017-05-15 |
| 1639625643 | Stephanie H Garris | Nurse Practitioner | 117 W Sevier Ave Ste 120, Kingsport, TN 37660 | 2016-08-30 |
| 1073965679 | Teresa Anne Starke | Physician Assistant | 8 Sheridan Square, Suite 110, Kingsport, TN 37660 | 2016-07-07 |
| Find all providers in zip 37660 | ||||
| Taxonomy Code | 103TH0100X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Health Service |
| A psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974). |
| Notes: Source: National Register of Health Service Providers in Psychology website http://www.nationalregister.org/about_NR.html [7/1/2006: modified title, added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184751984 | Ladonna Selby Carey | Psychologist | 1201 N Eastman Rd, Ste 122, Kingsport, TN 37664-3163 | 2007-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184193039 | Rebecca Ann Hansmann | Psychologist | 2721 Overhill Cir, Nashville, TN 37214-2819 | 2018-11-21 |
| 1386110112 | Esther Layne | Psychologist | 5466 Chesapeake Dr, Chattanooga, TN 37416-1478 | 2018-10-19 |
| 1700361904 | James Cowie | Psychologist | 156c West University Pkwy, Jackson, TN 38305 | 2018-10-03 |
| 1629570445 | De'armond Lyshawn Toney | Psychologist | 1903 Payne Rd, Chattanooga, TN 37421-2550 | 2018-03-07 |
| 1255848842 | Kristie M Anderson | Psychologist | 16 Laurel Lake Drive, Monteagle, TN 37356 | 2018-01-04 |
| 1144629072 | Bobby Rouse Sr. | Psychologist | 5152 Sequoia Rd, Memphis, TN 38117-2123 | 2014-08-15 |
| 1790023505 | Karen Rutledge | Psychologist | 6310 Jan Lane Dr, Harrison, TN 37341-4961 | 2013-01-29 |
| 1538494273 | Jerome H Morton | Psychologist | 349 Bmh Physicians Office Bldg, Maryville, TN 37804-5820 | 2009-10-14 |
| 1184859209 | Sara Jean Mccane-bowling | Psychologist | 10321 Red Water Ln, Knoxville, TN 37932-1580 | 2009-05-19 |
| 1508043084 | Shawn M Stewart | Psychologist | 1231 17th Ave S, Suite A, Nashville, TN 37212-2801 | 2008-01-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.