Organization Active NPI

Pharos Behavioral Health, PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Worcester, MA
National Provider Identifier
1639009269
Registry record updated Jul 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
PHAROS BEHAVIORAL HEALTH, PLLC
Practice address
100 Front St Ste 401
Worcester, MA 01608-1455
Phone
(774) 243-2624
NPI assigned
May 23, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2026

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

Authorized official

Name
Mr. Cheyne M Johnson, PMHNP-BCNPI 1508621608
Title
Managing Member
Phone
(774) 243-2624

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
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

100 Front St Ste 401
Worcester, MA 01608-1455

Mailing address

482 Southbridge St
PMB #363
Auburn, MA 01501-2468
Phone (774) 243-2624

National Provider Directory

National Provider Directory

Locations

482 Southbridge St
Auburn, MA 01501
Phone (508) 714-8837

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": "1779494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783123200000",
    "number": "1639009269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "482 SOUTHBRIDGE ST",
            "address_2": "PMB #363",
            "city": "AUBURN",
            "state": "MA",
            "postal_code": "015012468",
            "telephone_number": "774-243-2624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 FRONT ST STE 401",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081455",
            "telephone_number": "774-243-2624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHAROS BEHAVIORAL HEALTH, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-23",
        "last_updated": "2026-07-04",
        "certification_date": "2026-07-04",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CHEYNE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "774-243-2624",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2026; 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.