Pine Psychiatry

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

PINE PSYCHIATRY

Practice address

2 S Park St
Lebanon, NH 03766-1384

Phone

(603) 865-7157

NPI assigned

Nov 11, 2022

Organization subpart

No

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

Authorized official

Name

Timothy Bailey, APRNNPI 1063013423

Title

Owner

Phone

(603) 865-7157

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NH

Enrollment records 1

Locations

Practitioners 2

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

• Timothy Bailey, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Lebanon, NH
  • NPI 1063013423
  Medicare reassignment NPD Authorized official
• Clarisse A Charland, M.ED., MLADC

  • Addiction (Substance Use Disorder) Counselor
  • Hopkinton, NH
  • NPI 1952402851
  NPD (past)

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

{
    "created_epoch": "1668124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694563200000",
    "number": "1922716596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 S PARK ST",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037661384",
            "telephone_number": "603-865-7157",
            "fax_number": "603-709-2752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 S PARK ST",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037661384",
            "telephone_number": "603-865-7157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE PSYCHIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-11",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "603-865-7157",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shane Phipps
• Anna Janina Piatkowska, MD
• Harold J Pikus, MD
• Lucy J. Pilcher, LICSW
• Dana Mackin Pilchik, PSY.D.
• Pinewood Professionals, LLC
• Natalie A Pinkowski
• Roshini Pinto-Powell, M.D.
• Ryann Piotrowski, PA-C
• Catherine Florio Pipas

• Psychiatric/Mental Health Nurse Practitioner in Lebanon, NH
• Providers in Lebanon, NH by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.