# PINE PSYCHIATRY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922716596
- **Authorized official:** TIMOTHY BAILEY APRN (OWNER)
- **Authorized official phone:** (603) 865-7157

## Contact information

- **Practice address:** 2 S PARK ST, LEBANON, NH 03766-1384
- **Practice address phone:** (603) 865-7157
- **Mailing address:** 2 S PARK ST, LEBANON, NH 03766-1384
- **Mailing address phone:** (603) 865-7157
- **Mailing address fax:** (603) 709-2752

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 11/11/2022
- **Last updated:** 09/13/2023