Divine Behavioral Health Clinic PLLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

DIVINE BEHAVIORAL HEALTH CLINIC PLLC

Practice address

539 W Commerce St Ste 5507
Dallas, TX 75208-1953

Phone

(817) 874-2965

NPI assigned

Oct 16, 2023

Organization subpart

No

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

Authorized official

Name

Ijeoma E Osuji, PMHNP

Title

Owner

Phone

(817) 874-2965

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1697414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697673600000",
    "number": "1689456691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 MERYTON CT",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760634337",
            "telephone_number": "178-742-9658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "539 W COMMERCE ST STE 5507",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752081953",
            "telephone_number": "817-874-2965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE BEHAVIORAL HEALTH CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-16",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-17",
        "status": "A",
        "authorized_official_last_name": "OSUJI",
        "authorized_official_first_name": "IJEOMA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-874-2965",
        "authorized_official_credential": "PMHNP"
    },
    "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": []
}

• Divali Docs, PLLC (DFW Bariatrics and General Surgery)
• Abhay Ashok Divekar, MD, MBBS
• Diverge and Bloom Counseling, PLLC
• Diversicare Doctors LLC (Diversicare of Lake Highlands)
• Diversicare Treemont LLC (Treemont Healthcare and Rehabilitation Center)
• Divine Care Hospice LLC
• Divine Healing Space, PLLC
• Divine Healing Supplies
• Divine Medical Equipment, Inc
• Divine Medical Supply and Equipments LLC

• Psychiatric/Mental Health Nurse Practitioner in Dallas, TX
• Providers in Dallas, 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 Oct 19, 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.