Tri-State Area Behavioral Health LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

TRI-STATE AREA BEHAVIORAL HEALTH LLC

Practice address

1305 S Harvard St
Perryton, TX 79070-4412

Phone

(806) 202-8681

NPI assigned

Jan 23, 2023

Last updated

Jan 23, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kathi Boren, LPCNPI 1609258391

Title

Sole Member

Phone

(806) 202-8681

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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, and the practitioner matching its NPPES authorized official.

• Kathi Boren

  • Professional Counselor
  • Perryton, TX
  • NPI 1609258391
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674432000000",
    "number": "1407561541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 S HARVARD ST",
            "city": "PERRYTON",
            "state": "TX",
            "postal_code": "790704412",
            "telephone_number": "806-202-8681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 S HARVARD ST",
            "city": "PERRYTON",
            "state": "TX",
            "postal_code": "790704412",
            "telephone_number": "806-202-8681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-STATE AREA BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A",
        "authorized_official_last_name": "BOREN",
        "authorized_official_first_name": "KATHI",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "806-202-8681",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Dale Stevenson, CRNA
• Stratford Hospital District D/B/a Senior Valley Nursing Home
• Tamren Jade Terhune, MS, PLD
• Dana Michele Tow, APRN- FNP
• Jennifer Lynn Tracy, APRN
• United Supermarkets LLC (United Pharmacy #1325)
• United Supermarkets, LTD. (United Pharmacy 425)
• United Supermarkets, LTD. (United Pharmacy # 525)
• United Supermarkets, LTD. (United Pharmacy #425)
• Whitehead Chiropractic Health Center, LLC (Chiropractic Health Center)

• Professional Counselor in Perryton, TX
• Providers in Perryton, TX by specialty
• Professional Counselor in Texas

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