Tree of Life Behavioral Health Services Psychiatric NP, PC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

License

7905039 Issued in NY

Legal business name

TREE OF LIFE BEHAVIORAL HEALTH SERVICES PSYCHIATRIC NP, PC

Practice address

215 Washington St
Suite 221
Watertown, NY 13601-3329

Phone

(315) 286-0127

NPI assigned

May 6, 2013

Organization subpart

No

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

Authorized official

Name

Mrs. Anne Jeannette Nans, PNP FPMHNPNPI 1558582411

Title

Ceo

Phone

(315) 286-0127

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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.

• Anne Jeannette Nans, RN, PNP, FPMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Watertown, NY
  • NPI 1558582411
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1367798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678752000000",
    "number": "1285079137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 WASHINGTON ST STE 102",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136013343",
            "telephone_number": "315-286-0127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 WASHINGTON ST",
            "address_2": "SUITE 221",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136013329",
            "telephone_number": "315-286-0127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREE OF LIFE BEHAVIORAL HEALTH SERVICES PSYCHIATRIC NP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-06",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A",
        "authorized_official_last_name": "NANS",
        "authorized_official_first_name": "ANNE",
        "authorized_official_middle_name": "JEANNETTE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "315-286-0127",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PNP FPMHNP"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NY",
            "license": "7905039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03410015",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nora Kay Turner, LPN
• Ryan E Tyler, M.D.

• Adolescent and Children Mental Health Clinic/Center in Watertown, NY
• Providers in Watertown, NY by specialty
• Adolescent and Children Mental Health Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; 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.