| Papillon Behavioral Health, Llc | |
|
2514 1/2 Wesley St Ste 2 Johnson City TN 37601 | |
| (423) 529-0385 | |
| (423) 414-2699 |
| Full Name | Papillon Behavioral Health, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 2514 1/2 Wesley St Ste 2, Johnson City, Tennessee |
| Authorized Official Name and Position | Nicholas Porta (OWNER) |
| Authorized Official Contact | 4235290385 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Papillon Behavioral Health, Llc 2514 1/2 Wesley St Ste 2 Johnson City TN 37601-1754 Ph: (423) 529-0385 | Papillon Behavioral Health, Llc 2514 1/2 Wesley St Ste 2 Johnson City TN 37601 Ph: (423) 529-0385 |
| NPI Number | 1043728405 |
|---|---|
| Provider Enumeration Date | 01/18/2018 |
| Last Update Date | 06/07/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043728405 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | P0000003473 (Tennessee) | Primary |
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