Active NPI
Papillon Behavioral Health, LLC
- Psychologist
- Johnson City, TN
National Provider Identifier
1043728405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- P0000003473
- 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
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Nicholas Porta, PSYD
- Title
- Owner
- Phone
- (423) 529-0385
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | P0000003473 | TN | Primary |
Addresses
Primary practice location
2514 1/2 Wesley St Ste 2
Johnson City, TN 37601
Mailing address
2514 1/2 Wesley St Ste 2
Johnson City, TN 37601-1754
Phone (423) 529-0385
National Provider Directory
National Provider DirectoryLocations
2514 Wesley St
Ste 2
Johnson City, TN 37601
Phone (321) 441-6109
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Marriage & Family Therapist
- Johnson City, TN
- NPI 1811325194
NPI Registry JSON
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": []
}
Other providers in Johnson City, TN
Sources for this page
- 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.