Healthcare Provider Details

I. General information

NPI: 1841032562
Provider Name (Legal Business Name): POINT BEYOND MENTAL HEALTH COLLECTIVE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2024
Last Update Date: 06/18/2024
Certification Date: 06/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E SPRINGHILL DR STE L&M
TERRE HAUTE IN
47802-4439
US

IV. Provider business mailing address

500 E SPRINGHILL DR STE L&M
TERRE HAUTE IN
47802-4439
US

V. Phone/Fax

Practice location:
  • Phone: 812-221-1078
  • Fax:
Mailing address:
  • Phone: 812-221-1078
  • Fax: 812-413-2970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: KRYSTAL BILLINGSLEY
Title or Position: MANAGING PARTNER
Credential: MA, LMHC
Phone: 812-221-1078