Active NPI
Frontier Health
Doing business as Holston Children & Youth Services
- Adolescent and Children Mental Health Clinic/Center
- Kingsport, TN
National Provider Identifier
1578627006
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adolescent and Children Mental Health Clinic/Center
- License
- L 214-076-1417
- Legal business name
- FRONTIER HEALTH
- Doing business as
- Holston Children & Youth Services
- Practice address
- 2001 Stonebrook PL
Kingsport, TN 37660-4000 - Phone
- (423) 224-1000
- Fax
- (423) 224-1023
- NPI assigned
- Dec 20, 2006
- Last updated
- Dec 12, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Teresa M Kidd, PHD
- Title
- President and Ceo
- Phone
- (423) 467-3600
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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | L 214-076-1417 | TN | |
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X | L 214-076-1417 | TN | Primary |
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X | 316 | TN | |
| Community/Behavioral Health Agency | 251S00000X | L 214-076-1417 | TN |
Addresses
Primary practice location
2001 Stonebrook PL
Kingsport, TN 37660-4000
Mailing address
PO Box 9054
Gray, TN 37615-9054
Phone (423) 467-3600
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SAME AS MEDICARE #S | Medicaid | TN | |
| 49-4923-4 | Medicaid | VA |
Other names 1
- Holston Children & Youth Services
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040109000560 | TN | Part B Supplier - Clinic/Group Practice | 2860302320 |
Receives reassigned benefits from 124 practitioners 14 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Bristol, TN; Sneedville, TN; Rogersville, TN; Mountain City, TN; Kingsport, TN; Johnson City, TN; Greeneville, TN; Gray, TN… |
Other NPIs on the same Medicare enrollment 14
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Hawkins County Mental Health Clinic
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Rogersville, TN
- NPI 1043374564
O20040109000560
-
dba Hancock County Mental Health Center
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Sneedville, TN
- NPI 1053475558
O20040109000560
-
dba Fairview Associates of Johnson City
- Community/Behavioral Health Agency
- Johnson City, TN
- NPI 1134282551
O20040109000560
-
dba Bristol Regional Counseling Center
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Bristol, TN
- NPI 1235291295
O20040109000560
-
dba Adventure Program
- Adolescent and Children Mental Health Clinic/Center
- Johnson City, TN
- NPI 1235298720
O20040109000560
-
dba Watauga Behavioral Health Services
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Johnson City, TN
- NPI 1386700383
O20040109000560
-
dba Johnson County Counseling Center
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Mountain City, TN
- NPI 1396809851
O20040109000560
-
dba Erwin Mental Health Center
- Case Management Agency
- Erwin, TN
- NPI 1568524759
O20040109000560
-
dba Holston Counseling Center
- Community/Behavioral Health Agency
- Kingsport, TN
- NPI 1700940251
O20040109000560
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Gray, TN
- NPI 1720147408
O20040109000560
-
dba Nolachuckey -Holston Area Mental Health Center
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Greeneville, TN
- NPI 1760547004
O20040109000560
-
dba Tennessee Community Support Services
- Adult Mental Health Clinic/Center
- Bristol, TN
- NPI 1821154352
O20040109000560
National Provider Directory
National Provider Directory- Tax ID family
- Lee County Integrated Care
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Kingsport, TN
- NPI 1144460817
-
dba Crisis Triage
- Community/Behavioral Health Agency
- Johnson City, TN
- NPI 1174005276
-
dba Bristol Regional Counseling Center
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Bristol, TN
- NPI 1235291295
-
dba Adventure Program
- Adolescent and Children Mental Health Clinic/Center
- Johnson City, TN
- NPI 1235298720
-
dba Roller Russ Residence for Independent Living
- Mental Illness Community Based Residential Treatment Facility
- Kingsport, TN
- NPI 1265597280
-
dba Laurel House
- Mental Illness Community Based Residential Treatment Facility
- Johnson City, TN
- NPI 1265632392
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Bristol, TN
- NPI 1326288093
-
dba Watauga Behavioral Health Services
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Johnson City, TN
- NPI 1386700383
-
dba Johnson County Counseling Center
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Mountain City, TN
- NPI 1396809851
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Johnson City, TN
- NPI 1417197153
-
dba Supported Living - Kingsport
- Community/Behavioral Health Agency
- Kingsport, TN
- NPI 1508917642
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.
-
- Psychologist
- Greeneville, TN
- NPI 1386656403
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166572800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1544572800000",
"number": "1578627006",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9054",
"city": "GRAY",
"state": "TN",
"postal_code": "376159054",
"telephone_number": "423-467-3600",
"fax_number": "423-467-3644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2001 STONEBROOK PL",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376604000",
"telephone_number": "423-224-1000",
"fax_number": "423-224-1023"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FRONTIER HEALTH",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-20",
"last_updated": "2018-12-12",
"status": "A",
"authorized_official_last_name": "KIDD",
"authorized_official_first_name": "TERESA",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "PRESIDENT AND CEO",
"authorized_official_telephone_number": "423-467-3600",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PHD"
},
"taxonomies": [
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": "TN",
"license": "L 214-076-1417",
"primary": false
},
{
"code": "261QM0855X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adolescent and Children Mental Health",
"state": "TN",
"license": "L 214-076-1417",
"primary": true
},
{
"code": "261QR0405X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
"state": "TN",
"license": "316",
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "TN",
"license": "L 214-076-1417",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SAME AS MEDICARE #S",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "49-4923-4",
"state": "VA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Holston Children & Youth Services",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Holston Children & Youth Services",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Kingsport, TN
- Dawn Lacy Fritz, MED NCC LPC MHSP
- Letitia Bobbette Fritz
- Frontier Health
- Frontier Health (Roller Russ Residence for Independent Living)
- Frontier Health (Supported Living - Kingsport)
- Frontier Health (Holston Residence)
- Frontier Health (Holston Counseling Center)
- Frontier Health (Frontier Industries Kingsport)
- Frontier Health (Traces)
- Frontier Health (Midland Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2018; 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.