Rehoboth Mental Health and Psychiatry PLLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

REHOBOTH MENTAL HEALTH AND PSYCHIATRY PLLC

Practice address

1475 Heritage Pkwy Ste 209
Mansfield, TX 76063-2740

Phone

(817) 523-8812

Fax

(817) 241-1947

NPI assigned

Jun 27, 2024

Organization subpart

No

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

Authorized official

Name

Omotayo GbengaojoNPI 1972201895

Title

Owner/Authorised Official

Phone

(817) 523-8812

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Omotayo Theresa Gbengaojo, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Mansfield, TX
  • NPI 1972201895
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1719446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765843200000",
    "number": "1053156331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 HERITAGE PKWY STE 209",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760632740",
            "telephone_number": "817-523-8812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 HERITAGE PKWY STE 209",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760632740",
            "telephone_number": "817-523-8812",
            "fax_number": "817-241-1947"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5900 Balcones Dr",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787314257",
            "country_code": "US",
            "telephone_number": "817-523-8812 x38812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REHOBOTH MENTAL HEALTH AND PSYCHIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-27",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A",
        "authorized_official_last_name": "GBENGAOJO",
        "authorized_official_first_name": "OMOTAYO",
        "authorized_official_title_or_position": "OWNER/AUTHORISED OFFICIAL",
        "authorized_official_telephone_number": "817-523-8812"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Mansfield, TX
• Providers in Mansfield, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.