Roann Behavioral Health Clinic PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

ROANN BEHAVIORAL HEALTH CLINIC PLLC

Practice address

6500 Northwest Dr Ste 350E
Mesquite, TX 75150-6849

Phone

(214) 272-3167

Fax

(214) 272-3749

NPI assigned

Oct 26, 2022

Organization subpart

No

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

Authorized official

Name

Ekeoma CooperNPI 1578029534

Title

Practice Manager

Phone

(214) 272-3167

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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.

• Ekeoma I Cooper

  • Gerontology Nurse Practitioner
  • Mesquite, TX
  • NPI 1578029534

  Multi-Specialty, TX

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1666742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668988800000",
    "number": "1962129288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 NORTHWEST DR STE 350E",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751506849",
            "telephone_number": "214-272-3167",
            "fax_number": "214-272-3749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 NORTHWEST DR STE 350E",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751506849",
            "telephone_number": "214-272-3167",
            "fax_number": "214-272-3749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROANN BEHAVIORAL HEALTH CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-26",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "EKEOMA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "214-272-3167"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Mesquite, TX
• Mental Health Clinic/Center (Including Community Mental Health Center) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; 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.