Organization Active NPI

Horizon Integrative Psychotherapy, LLC

  • Mental Health Counselor
  • Springfield, MA
National Provider Identifier
1467127944
Registry record updated Aug 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
HORIZON INTEGRATIVE PSYCHOTHERAPY, LLC
Practice address
91 Mill St Ste I
Springfield, MA 01108-9100
Phone
(413) 266-2214
Fax
(413) 294-6266
NPI assigned
Aug 16, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2021

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

Authorized official

Name
Glenroy Bristol, LMHC; M.EDNPI 1841442993
Title
Owner
Phone
(413) 266-2214

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

91 Mill St Ste I
Springfield, MA 01108-9100

Mailing address

91 Mill St Ste I
Springfield, MA 01108-9100
Phone (413) 266-2214

Other identifiers 1

IdentifierTypeStateIssuer
1841442993MedicaidMA

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Springfield Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251226000860 MA Part B Supplier - Clinic/Group Practice 8820584055 Receives reassigned benefits from 1 practitioner
Practice locations: Springfield, MA

National Provider Directory

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.

NPI Registry JSON

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

{
    "created_epoch": "1629072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629072000000",
    "number": "1467127944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 MILL ST STE I",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011089100",
            "telephone_number": "413-266-2214",
            "fax_number": "413-294-6266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 MILL ST STE I",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011089100",
            "telephone_number": "413-266-2214",
            "fax_number": "413-294-6266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HORIZON INTEGRATIVE PSYCHOTHERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-16",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A",
        "authorized_official_last_name": "BRISTOL",
        "authorized_official_first_name": "GLENROY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "413-266-2214",
        "authorized_official_credential": "LMHC; M.ED"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841442993",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Springfield",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "91 Mill St Ste I",
            "city": "Springfield",
            "state": "MA",
            "country_code": "US",
            "postal_code": "011089100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; 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.