Pinnacle Enrichment Healthcare Services, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH-2462 Issued in TN

Legal business name

PINNACLE ENRICHMENT HEALTHCARE SERVICES, LLC

Practice address

1300 Mercantile LN Ste 150
Largo, MD 20774-5334

Phone

(901) 270-8002

NPI assigned

Mar 5, 2018

Last updated

Mar 5, 2018By 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

Dr. Myron V. Johnson, DOCTOR OF PSYCHOLOGY

Title

Principal/ Owner

Phone

(901) 270-8002

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1520208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520208000000",
    "number": "1760984868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 MERCANTILE LN STE 150",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745334",
            "telephone_number": "901-270-8002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MERCANTILE LN STE 150",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745334",
            "telephone_number": "901-270-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE ENRICHMENT HEALTHCARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-05",
        "last_updated": "2018-03-05",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MYRON",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "PRINCIPAL/ OWNER",
        "authorized_official_telephone_number": "901-270-8002",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DOCTOR OF PSYCHOLOGY"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "MH-2462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2018; 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.