Provider Demographics
NPI:1881475770
Name:BLUEPRINT INTEGRATIVE MENTAL HEALTH
Entity type:Organization
Organization Name:BLUEPRINT INTEGRATIVE MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:TAYLOR
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:615-559-5826
Mailing Address - Street 1:4880 PYLES RD
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37034-2656
Mailing Address - Country:US
Mailing Address - Phone:615-559-5826
Mailing Address - Fax:
Practice Address - Street 1:4880 PYLES RD
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:TN
Practice Address - Zip Code:37034-2656
Practice Address - Country:US
Practice Address - Phone:615-205-8692
Practice Address - Fax:615-908-5849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-09
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health