MOUNTAIN STATES HEALTH ALLIANCE OUT-PATIENT BEHAVIORAL HEALTH is a health service psychologist in Kingsport, TN. The provider is a psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974). MOUNTAIN STATES HEALTH ALLIANCE OUT-PATIENT BEHAVIORAL HEALTH NPI is 1083936033. The provider is registered as an organization entity type and is a single specialty group.
The provider's business location address is:
2012 BROOKSIDE DR
KINGSPORT, TN
ZIP 37660-645
Phone: (423) 857-5566
Fax: (423) 857-5564
The provider's authorized official is Graciela Pereira .
The authorized official title is Avp Behavioral Health And Rehab Ser and has the following contact phone number (423) 952-1701.
The CLIA number assigned to this NPI record is 44D0970044 - ambulatory surgery center with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 2/18/2010 and was last updated on 2/18/2010.