Therapeutic Village LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

THERAPEUTIC VILLAGE LLC

Practice address

8386 Six Forks Rd Ste 101
Raleigh, NC 27615-5088

Phone

(336) 933-1204

Fax

(336) 510-0926

NPI assigned

Sep 28, 2024

Organization subpart

No

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

Authorized official

Name

Keymian Crisp

Title

Practice Manager

Phone

(336) 510-0653

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1727481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729641600000",
    "number": "1285452375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8386 SIX FORKS RD STE 101",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276155088",
            "telephone_number": "336-933-1204",
            "fax_number": "336-510-0926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8386 SIX FORKS RD STE 101",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276155088",
            "telephone_number": "336-933-1204",
            "fax_number": "336-510-0926"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "203 W Nash St",
            "address_purpose": "LOCATION",
            "city": "Louisburg",
            "state": "NC",
            "postal_code": "275492527",
            "country_code": "US",
            "telephone_number": "336-510-0653",
            "fax_number": "336-510-0926",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2157 Raleigh Rd",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NC",
            "postal_code": "275365761",
            "country_code": "US",
            "telephone_number": "336-510-0653",
            "fax_number": "336-510-0926",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "211 S Jarvis St",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278582052",
            "country_code": "US",
            "telephone_number": "336-510-0653",
            "fax_number": "336-510-0926",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "221 1st Ave W Ste 200",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981194223",
            "country_code": "US",
            "telephone_number": "336-510-0653",
            "fax_number": "336-510-9627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THERAPEUTIC VILLAGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-28",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A",
        "authorized_official_last_name": "CRISP",
        "authorized_official_first_name": "KEYMIAN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "336-510-0653"
    },
    "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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• Therapeutic Partners, PLLC
• Therapies in Partnership
• Theraplay Bilingual Solutions, LLC
• Therapy Discoveries
• Therapy Party, PLLC
• Therapy Plus Inc

• Psychiatric/Mental Health Nurse Practitioner in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Psychiatric/Mental Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.