Emex Behavoral Health Clinic

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

EMEX BEHAVORAL HEALTH CLINIC

Practice address

410 NW 11TH St Ste 107
Grand Prairie, TX 75050-5416

Phone

(214) 218-6302

NPI assigned

Oct 12, 2024

Organization subpart

No

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

Authorized official

Name

Angela OlukitibiNPI 1891514832

Title

Pmhnp- BC

Phone

(214) 218-6302

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Angela Olukitibi, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Grand Prairie, TX
  • NPI 1891514832
  NPD Authorized official

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

{
    "created_epoch": "1728691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728691200000",
    "number": "1265252555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 NW 11TH ST STE 107",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750505416",
            "telephone_number": "214-218-6302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 NW 11TH ST STE 107",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750505416",
            "telephone_number": "214-218-6302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMEX BEHAVORAL HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-12",
        "last_updated": "2024-10-12",
        "certification_date": "2024-10-07",
        "status": "A",
        "authorized_official_last_name": "OLUKITIBI",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "PMHNP- BC",
        "authorized_official_telephone_number": "214-218-6302"
    },
    "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": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Grand Prairie, TX
• Providers in Grand Prairie, 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 Oct 12, 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.