NPIMap

Organization Active NPI

Harbor of Hope Medical and Behavioral Health Care, LLC

  • Psychiatry Physician
  • Barbourville, KY
National Provider Identifier
1639875693
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
HARBOR OF HOPE MEDICAL AND BEHAVIORAL HEALTH CARE, LLC
Practice address
185 Treuhaft Blvd
Suite 4
Barbourville, KY 40906
Phone
(606) 546-6766
Fax
(606) 545-0366
NPI assigned
Feb 1, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

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

Authorized official

Name
Thelma Jean Gray, APRNNPI 1548755499
Title
Aprn/Owner
Phone
(606) 545-6766

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

185 Treuhaft Blvd
Suite 4
Barbourville, KY 40906

Mailing address

185 Treuhaft Blvd
Suite 4
Barbourville, KY 40906
Phone (606) 546-6766

Other identifiers 1

IdentifierTypeStateIssuer
7100661760MedicaidKY

National Provider Directory

National Provider Directory
Tax ID family
Harbor of Hope Medical and Behavioral Health Care LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the 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": "1675209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675209600000",
    "number": "1639875693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 TREUHAFT BLVD",
            "address_2": "SUITE 4",
            "city": "BARBOURVILLE",
            "state": "KY",
            "postal_code": "40906",
            "telephone_number": "606-546-6766",
            "fax_number": "606-545-0366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 TREUHAFT BLVD",
            "address_2": "SUITE 4",
            "city": "BARBOURVILLE",
            "state": "KY",
            "postal_code": "40906",
            "telephone_number": "606-546-6766",
            "fax_number": "606-545-0366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR OF HOPE MEDICAL AND BEHAVIORAL HEALTH CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-01",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "THELMA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "APRN/OWNER",
        "authorized_official_telephone_number": "606-545-6766",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100661760",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Barbourville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; 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.