Healthcare Provider Details

I. General information

NPI: 1124941356
Provider Name (Legal Business Name): COMMON GROUND TRAUMA AND BEHAVIORAL HEALTH INSTITUTE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 RIVER GROVE WAY
WEST PALM BEACH FL
33407-2137
US

IV. Provider business mailing address

7754 OKEECHOBEE BLVD # 795
WEST PALM BEACH FL
33411-2103
US

V. Phone/Fax

Practice location:
  • Phone: 423-521-1978
  • Fax:
Mailing address:
  • Phone: 786-505-5034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: JANELLE BILLINGY
Title or Position: OWNER
Credential: LCSW
Phone: 423-521-1978