FOUR COUNTY COMPREHENSIVE MENTAL HEALTH CENTER INC NPI 1972545945

NPI Information

NPI: 1972545945
Provider Name: FOUR COUNTY COMPREHENSIVE MENTAL HEALTH CENTER INC

Doing Business As: FOUR COUNTY COUNSELING CENTER

Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
1015 MICHIGAN AVE
LOGANSPORT, IN
ZIP 46947
Phone: (574) 722-5151
Get Directions

FOUR COUNTY COMPREHENSIVE MENTAL HEALTH CENTER INC is a mental health (including community mental health center) clinic center in Logansport, IN. FOUR COUNTY COMPREHENSIVE MENTAL HEALTH CENTER INC NPI is 1972545945. The provider is registered as an organization entity type.
The provider Is Doing Business As Four County Counseling Center.

The provider's business location address is:

1015 MICHIGAN AVE
LOGANSPORT, IN
ZIP 46947-527
Phone: (574) 722-5151
Fax: (574) 739-1414

The provider's authorized official is Jason Cadwell .
The authorized official title is Cfo and has the following contact phone number (574) 722-5151.

The CLIA number assigned to this NPI record is 15D0881668 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/12/2006 and was last updated on 2/22/2016.

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	License Number	License State	Primary
1	261QR0400X	Clinic/Center	Rehabilitation	427-0-CMHC	INDIANA	No
2	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	427-0-CMHC	INDIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	100464740	MEDICAID	INDIANA
2	111810	MEDICARE PIN	INDIANA

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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