Hagerstown Integrative Mental Health

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

HAGERSTOWN INTEGRATIVE MENTAL HEALTH

Practice address

1185 Mount Aetna Rd Ste 102
Hagerstown, MD 21740-6832

Phone

(865) 804-4067

NPI assigned

Mar 7, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Christopher Gabriel Bennett, MSN, CRNP

Title

Psychiatric Nurse Practitioner

Phone

(865) 804-4067

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1583539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583539200000",
    "number": "1861027146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14315 LUELLA PL",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217401186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1185 MOUNT AETNA RD STE 102",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217406832",
            "telephone_number": "865-804-4067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAGERSTOWN INTEGRATIVE MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-07",
        "last_updated": "2020-03-07",
        "certification_date": "2020-03-07",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "GABRIEL",
        "authorized_official_title_or_position": "PSYCHIATRIC NURSE PRACTITIONER",
        "authorized_official_telephone_number": "865-804-4067",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSN, CRNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Hagerstown, MD
• Providers in Hagerstown, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.