Ebbtide Behavioral Health Associates PLLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

EBBTIDE BEHAVIORAL HEALTH ASSOCIATES PLLC

Practice address

83 Lafayette Rd Unit 47-B
Hampton Falls, NH 03844-2303

Phone

(802) 793-9177

NPI assigned

Feb 28, 2023

Last updated

Aug 9, 2023By 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

Tasha L Humphreys, APRNNPI 1851717953

Title

Provider

Phone

(802) 793-9177

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NH

Enrollment records 1

Locations

Practitioners 1

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.

• Tasha L Humphreys, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Exeter, NH
  • NPI 1851717953
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1677542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691539200000",
    "number": "1932808953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 LAFAYETTE RD UNIT 47-B",
            "city": "HAMPTON FALLS",
            "state": "NH",
            "postal_code": "038442303",
            "telephone_number": "802-793-9177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 LAFAYETTE RD UNIT 47-B",
            "city": "HAMPTON FALLS",
            "state": "NH",
            "postal_code": "038442303",
            "telephone_number": "802-793-9177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBBTIDE BEHAVIORAL HEALTH ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-28",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A",
        "authorized_official_last_name": "HUMPHREYS",
        "authorized_official_first_name": "TASHA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "802-793-9177",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3095969",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kiley Corson, MS, CCC-SLP
• Crysdi Medical LLC
• Josephina Debicki
• Doris Donoghue, R.N.
• Olivia Dube
• Emily M Fraser
• Hampton Falls School District
• Kayla Elizabeth Hansen, M.A. CCC-SLP
• Tess Hutchins, SLP
• Julia Izzo

• Psychiatric/Mental Health Nurse Practitioner in Hampton Falls, NH
• Providers in Hampton Falls, 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 Aug 9, 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.