Profound Performance LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PROFOUND PERFORMANCE LLC

Practice address

641 Upper St
Danville, VA 24541-1031

Phone

(434) 288-7805

Fax

(434) 228-7813

NPI assigned

Jun 17, 2024

Organization subpart

No

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

Authorized official

Name

Tameaka Blackwell, BS

Title

Ceo

Phone

(434) 429-0024

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718582400000",
    "number": "1851134746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "641 UPPER ST",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245411031",
            "telephone_number": "434-288-7805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "641 UPPER ST",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245411031",
            "telephone_number": "434-288-7805",
            "fax_number": "434-228-7813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFOUND PERFORMANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A",
        "authorized_official_last_name": "BLACKWELL",
        "authorized_official_first_name": "TAMEAKA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "434-429-0024",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Danville, VA
• Providers in Danville, VA by specialty
• Community/Behavioral Health Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; 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.