MENTAL HEALTH AND WELLNESS ON MAIN NPI 1336872381

NPI Information

NPI: 1336872381
Provider Name: MENTAL HEALTH AND WELLNESS ON MAIN
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

CLIA Number: 04D2267393

Address:
275 MAIN ST
MAMMOTH SPRING, AR
ZIP 72554
Phone: (913) 787-5292
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MENTAL HEALTH AND WELLNESS ON MAIN is a mental health (including community mental health center) clinic center in Mammoth Spring, AR. MENTAL HEALTH AND WELLNESS ON MAIN NPI is 1336872381. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

275 MAIN ST
MAMMOTH SPRING, AR
ZIP 72554-484
Phone: (913) 787-5292
Fax: (870) 606-2709

The provider's authorized official is Laura Collette Young .
The authorized official title is Ceo/prescriber and has the following contact phone number (913) 787-5292.

The CLIA number assigned to this NPI record is 04D2267393 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/7/2022 and was last updated on 11/8/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	1041C0700X	Social Worker	Clinical	No
2	101YM0800X	Counselor	Mental Health	No
3	136A00000X	Dietetic Technician, Registered		No
4	171M00000X	Case Manager/Care Coordinator		No
5	2084P0800X	Psychiatry & Neurology	Psychiatry	No
6	2084P0804X	Psychiatry & Neurology	Child & Adolescent Psychiatry	No
7	2084P0805X	Psychiatry & Neurology	Geriatric Psychiatry	No
8	235Z00000X	Speech-Language Pathologist		No
9	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	No
10	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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