Brookhaven Youth Ranch, Inc.

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

236482 Issued in TX

Legal business name

BROOKHAVEN YOUTH RANCH, INC.

Practice address

5467 Rogers Hill Rd
West, TX 76691-2415

Phone

(254) 829-1893

Fax

(254) 829-1469

NPI assigned

Feb 12, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Bill Gholson, MSW

Title

Executive Director

Phone

(254) 829-1893

Specialties & licenses 1

Addresses

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kathilyn Beard, LCSW

  • Social Worker
  • West, TX
  • NPI 1043352867
  NPD (past)
• Danielle J. Bryant, LMFT

  • Marriage & Family Therapist
  • West, TX
  • NPI 1225595127
  NPD (past)
• Terry Lynn Moore, MS, LPC, LCCA

  • Professional Counselor
  • West, TX
  • NPI 1841831534
  NPD (past)
• Kira Nunn

  • Professional Counselor
  • West, TX
  • NPI 1043528995
  NPD (past)

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740321686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5467 ROGERS HILL RD",
            "city": "WEST",
            "state": "TX",
            "postal_code": "766912415",
            "telephone_number": "254-829-1893",
            "fax_number": "254-829-1469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5467 ROGERS HILL RD",
            "city": "WEST",
            "state": "TX",
            "postal_code": "766912415",
            "telephone_number": "254-829-1893",
            "fax_number": "254-829-1469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKHAVEN YOUTH RANCH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GHOLSON",
        "authorized_official_first_name": "BILL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "254-829-1893",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "TX",
            "license": "236482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandy S Abel, BSW, RBT
• Accureview Inc.
• Kathilyn Beard, LCSW
• Kayla Bettge
• Haylee Boyd
• Paula Brown, RN
• Danielle J. Bryant, LMFT
• Cade Y. Erwin, DDS PLLC
• Chasity Camacho, PTA
• Kristi Chudej

• Emotionally Disturbed Childrens' Residential Treatment Facility in West, TX
• Providers in West, TX by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.