Olive Branch Clinic LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

OLIVE BRANCH CLINIC LLC

Practice address

2000 Auburn Dr Ste 200
Beachwood, OH 44122-4328

Phone

(216) 300-7500

Fax

(216) 300-1900

NPI assigned

Aug 5, 2026

Organization subpart

No

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

Authorized official

Name

Ms. Teara Nicole Young, MSN, PMHNP-BC, DNP-C

Title

Owner/Provider

Phone

(216) 300-7500

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1785888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785888000000",
    "number": "1154245082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 AUBURN DR STE 200",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441224328",
            "telephone_number": "216-300-7500",
            "fax_number": "216-300-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 AUBURN DR STE 200",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441224328",
            "telephone_number": "216-300-7500",
            "fax_number": "216-300-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVE BRANCH CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-05",
        "last_updated": "2026-08-05",
        "certification_date": "2026-07-23",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "TEARA",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "216-300-7500",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSN, PMHNP-BC, DNP-C"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "719448",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2026; 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.