Simply Teen Outpatient

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SIMPLY TEEN OUTPATIENT

Practice address

800 W Williams St Ste 203
Apex, NC 27502-5200

Phone

(919) 869-5301

Fax

(855) 678-6632

NPI assigned

Sep 14, 2021

Organization subpart

No

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

Authorized official

Name

Ms. Tina Marie Kinnan, MRC, LCMHCSNPI 1205133386

Title

Owner/Therapist

Phone

(919) 869-5301

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Tina Marie Kinnan, LPC

  • Professional Counselor
  • Cary, NC
  • NPI 1205133386
  NPD Authorized official
• Alexis Kim

  • Mental Health Counselor
  • Cary, NC
  • NPI 1760078463
  NPD

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

{
    "created_epoch": "1631577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631577600000",
    "number": "1730859513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 W WILLIAMS ST STE 203",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275025200",
            "telephone_number": "919-869-5301",
            "fax_number": "855-678-6632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W WILLIAMS ST STE 203",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275025200",
            "telephone_number": "919-869-5301",
            "fax_number": "855-678-6632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMPLY TEEN OUTPATIENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-14",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A",
        "authorized_official_last_name": "KINNAN",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "919-869-5301",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MRC, LCMHCS"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anjali Shroff, RPH
• Corrine Shuster
• Furqaan Hasan Siddiqui, DDS
• Somvattana Dewey Siharath
• Lena Silverman, M.S. CCC-SLP
• Charles H Simpson III, D.D.S.
• Pamela Lynn Skinner, MOT, OTR/L
• Janet Riley Slay
• Kylie D Slusser
• Smiling Spirit Pathways LLC

• Community/Behavioral Health Agency in Apex, NC
• Providers in Apex, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; 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.