NPIMap

Organization Active NPI

Stonegate Behavioral Health PC

  • Mental Health Counselor
  • Keller, TX
National Provider Identifier
1306019468
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
STONEGATE BEHAVIORAL HEALTH PC
Practice address
4686 Bristol Trace TRL
Keller, TX 76248-6947
Phone
(817) 300-1590
NPI assigned
Apr 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

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

Authorized official

Name
Joe EasthamNPI 1043332836
Title
Executive Director
Phone
(817) 300-1590

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

4686 Bristol Trace TRL
Keller, TX 76248-6947

Mailing address

4686 Bristol Trace TRL
Keller, TX 76248-6947
Phone (817) 300-1590

Other names 1

  • Andre Punch Other name

National Provider Directory

National Provider Directory
Tax ID family
Andre Punch4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the 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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207785600000",
    "number": "1306019468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4686 BRISTOL TRACE TRL",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762486947",
            "telephone_number": "817-300-1590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4686 BRISTOL TRACE TRL",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762486947",
            "telephone_number": "817-300-1590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONEGATE BEHAVIORAL HEALTH PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-10",
        "last_updated": "2008-04-10",
        "status": "A",
        "authorized_official_last_name": "EASTHAM",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "817-300-1590"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Andre Punch",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Keller, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; 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.