Healthcare Provider Details

I. General information

NPI: 1538080676
Provider Name (Legal Business Name): BLUE MATTER PSYCHIATRY AND MENTAL HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4307 N ROAN ST STE 10
JOHNSON CITY TN
37615-4973
US

IV. Provider business mailing address

4307 N ROAN ST STE 10
JOHNSON CITY TN
37615-4973
US

V. Phone/Fax

Practice location:
  • Phone: 423-607-1777
  • Fax: 423-500-7008
Mailing address:
  • Phone: 423-607-1777
  • Fax: 423-500-7008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: STACY AMANDA MORRIS
Title or Position: OWNER
Credential: DO
Phone: 423-607-1777