Organization Active NPI

Your Psych NP LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Austin, TX
National Provider Identifier
1063281038
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
YOUR PSYCH NP LLC
Practice address
612 W 22ND St
Austin, TX 78705-5104
Phone
(512) 515-9434
Fax
(682) 651-1468
NPI assigned
Jan 1, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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

Authorized official

Name
Trecy Bergen, PMHNP-BCNPI 1134735079
Title
Pmhnp- BC
Phone
(828) 482-2174

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

612 W 22ND St
Austin, TX 78705-5104

Mailing address

1304 Fernwood Rd
Austin, TX 78722-1028
Phone (828) 482-2174

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1704067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708560000000",
    "number": "1063281038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 FERNWOOD RD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787221028",
            "telephone_number": "828-482-2174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 W 22ND ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787055104",
            "telephone_number": "512-515-9434",
            "fax_number": "682-651-1468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR PSYCH NP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-01",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A",
        "authorized_official_last_name": "BERGEN",
        "authorized_official_first_name": "TRECY",
        "authorized_official_title_or_position": "PMHNP- BC",
        "authorized_official_telephone_number": "828-482-2174",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; 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.