Living Spring Family Psychiatry

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

LIVING SPRING FAMILY PSYCHIATRY

Doing business as

Living Spring Family Psychiatry

Practice address

811 W Jefferson St
Grand Prairie, TX 75051-1645

Phone

(214) 662-2675

NPI assigned

Jul 8, 2024

Last updated

Sep 6, 2024By 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

Mr. Olushola A Balogun, NPNPI 1649026998

Title

Ceo

Phone

(214) 662-2675

Specialties & licenses 1

Addresses

Other names 1

• Living Spring Family Psychiatry Doing business as

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.

• Olushola A. Balogun, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Grand Prairie, TX
  • NPI 1649026998
  Authorized official Same address or phone

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

{
    "created_epoch": "1720396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725580800000",
    "number": "1588400709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 W JEFFERSON ST",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750511645",
            "telephone_number": "214-662-2675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 W JEFFERSON ST",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750511645",
            "telephone_number": "214-662-2675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING SPRING FAMILY PSYCHIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-08",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A",
        "authorized_official_last_name": "BALOGUN",
        "authorized_official_first_name": "OLUSHOLA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-662-2675",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Living Spring Family Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Living Spring Family Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Psychiatric/Mental Health Nurse Practitioner in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.