NPIMap

Organization Active NPI

York TMS Clinic, LLC

  • Adult Mental Health Clinic/Center
  • York, PA
National Provider Identifier
1972374973
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
YORK TMS CLINIC, LLC
Practice address
1493 South Queen Street
York, PA 17403-3852
Phone
(717) 430-0434
Fax
(717) 854-0242
NPI assigned
Jan 10, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Authorized official

Name
Gracia Etienne, MDNPI 1669479788
Title
Authorized Official
Phone
(717) 430-0434

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

1493 South Queen Street
York, PA 17403-3852

Mailing address

1493 South Queen Street
York, PA 17403-3852
Phone (717) 430-0434

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240613000981 PA Part B Supplier - Clinic/Group Practice 0345782736 Receives reassigned benefits from 3 practitioners
Practice locations: York, PA

National Provider Directory

National Provider Directory

Locations

1806 N George St
York, PA 17404
Phone (717) 430-0434

1405 Dewar Dr
Rock Springs, WY 82901
Phone (877) 991-7744

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1704844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717545600000",
    "number": "1972374973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1493 SOUTH QUEEN STREET",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174033852",
            "telephone_number": "717-430-0434",
            "fax_number": "717-854-0242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1493 SOUTH QUEEN STREET",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174033852",
            "telephone_number": "717-430-0434",
            "fax_number": "717-854-0242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YORK TMS CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-10",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A",
        "authorized_official_last_name": "ETIENNE",
        "authorized_official_first_name": "GRACIA",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "717-430-0434",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.