C-Trilogy Comprehensive Clinical Care, PLLC

Primary specialty

Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X

License

AP125290 Issued in TX

Legal business name

C-TRILOGY COMPREHENSIVE CLINICAL CARE, PLLC

Practice address

618 N High St Ste 3
Longview, TX 75601-5377

Phone

(903) 234-8755

NPI assigned

Dec 14, 2015

Organization subpart

No

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

Authorized official

Name

Tracy HicksNPI 1215353651

Title

Owner

Phone

(903) 234-8755

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tracy Hicks, APRN, FNP/PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Longview, TX
  • NPI 1215353651
  Medicare reassignment Authorized official
• Latoya Nichelle Allen-Costict, BSN, RN

  • Psychiatric/Mental Health Registered Nurse
  • Longview, TX
  • NPI 1417525270
  NPD
• Pamela Annette Bradley, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Longview, TX
  • NPI 1437938495
  NPD (past)
• Samjhana Shrestha, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Longview, TX
  • NPI 1972450922
  NPD (past)
• Comesha S Talley, FNP

  • Family Nurse Practitioner
  • Longview, TX
  • NPI 1427827906
  NPD (past)

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

{
    "created_epoch": "1450051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668384000000",
    "number": "1730554999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 N HIGH ST STE 3",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015377",
            "telephone_number": "903-234-8755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 N HIGH ST STE 3",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015377",
            "telephone_number": "903-234-8755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C-TRILOGY COMPREHENSIVE CLINICAL CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-14",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A",
        "authorized_official_last_name": "HICKS",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-234-8755"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP125290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084816001",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wecare4u@ctrilogy.com",
            "affiliation": "N",
            "address_1": "618 N High St Ste 3",
            "city": "Longview",
            "state": "TX",
            "country_code": "US",
            "postal_code": "756015377",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wecare4u@ctrilogy.com",
            "affiliation": "N",
            "address_1": "618 N High St Ste 3",
            "city": "Longview",
            "state": "TX",
            "country_code": "US",
            "postal_code": "756015377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tamara Lachelsa Bush
• William Edward Bussey, DDS
• Jacqueline Fontenot Butler, MD
• Tonya Butler
• Danielle Bybee
• Staci Cabbiness, LPC
• Kai Cade
• Rajani Ruth Caesar, MD
• Connie Caldwell
• Tessa Callaway, RBT

• Psychiatric/Mental Health Clinical Nurse Specialist in Longview, TX
• Providers in Longview, TX by specialty
• Psychiatric/Mental Health Clinical Nurse Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.