Healthcare Provider Details

I. General information

NPI: 1639009269
Provider Name (Legal Business Name): PHAROS BEHAVIORAL HEALTH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2026
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82 WENDELL AVE STE 100
PITTSFIELD MA
01201-7066
US

IV. Provider business mailing address

482 SOUTHBRIDGE ST
AUBURN MA
01501-2468
US

V. Phone/Fax

Practice location:
  • Phone: 774-243-2624
  • Fax:
Mailing address:
  • Phone: 774-243-2624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. CHEYNE M JOHNSON
Title or Position: MANAGING MEMBER
Credential: PMHNP-BC
Phone: 774-243-2624