Papillon Behavioral Health, LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

P0000003473 Issued in TN

Legal business name

PAPILLON BEHAVIORAL HEALTH, LLC

Practice address

2514 1/2 Wesley St Ste 2
Johnson City, TN 37601

Phone

(423) 529-0385

Fax

(423) 414-2699

NPI assigned

Jan 18, 2018

Last updated

Jun 7, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Nicholas Porta, PSYDNPI 1013387687

Title

Owner

Phone

(423) 529-0385

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nicholas Porta, PSYD

  • Psychologist
  • Johnson City, TN
  • NPI 1013387687
  Authorized official Same address or phone
• Jennifer E Miller, LMFT

  • Marriage & Family Therapist
  • Johnson City, TN
  • NPI 1811325194
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1516233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528329600000",
    "number": "1043728405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2514 1/2 WESLEY ST STE 2",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011754",
            "telephone_number": "423-529-0385",
            "fax_number": "423-414-2699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2514 1/2 WESLEY ST STE 2",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37601",
            "telephone_number": "423-529-0385",
            "fax_number": "423-414-2699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAPILLON BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-18",
        "last_updated": "2018-06-07",
        "status": "A",
        "authorized_official_last_name": "PORTA",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-529-0385",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "TN",
            "license": "P0000003473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Li Pang, MD
• Stephanie Panoncillo, AUD
• Leslie Weylon Panus, M.D.
• Salvatore Paolillo, M.D.
• Konstantinos Papas, MD
• Nili M Parekh, MD
• John Parigger
• Claire D Paris, M.D.
• Habeeba Park, M.D.
• Abigail Parker-Repsher

• Psychologist in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.