Organization · Type 2 NPI

Frontier Health

Adolescent and Children Mental Health Clinic/Center · Kingsport, TN

NPI number 1578627006 Active

Practice location

2001 Stonebrook Pl
Kingsport, TN 37660-4000

Call (423) 224-1000 Map

Fax (423) 224-1023

Mailing address

PO Box 9054
Gray, TN 37615-9054

Specialties and licenses

Taxonomy	Code	License
Case Management Agency	251B00000X	L 214-076-1417 (TN)
Community/Behavioral Health Agency	251S00000X	L 214-076-1417 (TN)
Adolescent and Children Mental Health Clinic/Center Primary	261QM0855X	L 214-076-1417 (TN)
Substance Use Disorder Rehabilitation Clinic/Center	261QR0405X	316 (TN)

Adolescent and Children Mental Health Clinic/Center: An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.

29 other providers at this address

NPI record

NPI: 1578627006
Entity type: Organization (Type 2)
Issued: Dec 20, 2006
Last updated: Dec 12, 2018
Status: Active

Other names

<unavail>
Holston Children & Youth Services · doing business as
Holston Children & Youth Services · doing business as

Authorized official

Dr. Teresa M Kidd, PhD
President and CEO
(423) 467-3600

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1578627006

Frontier Health's National Provider Identifier is 1578627006, issued on Dec 20, 2006. The primary taxonomy on file is Adolescent and Children Mental Health Clinic/Center (261QM0855X), and the practice location is in Kingsport, TN. The record was last updated on Dec 12, 2018.