SHAWNEE MENTAL HEALTH CENTER INC. NPI 1225508195

NPI Information

NPI: 1225508195
Provider Name: SHAWNEE MENTAL HEALTH CENTER, INC.

Doing Business As: DBA SHAWNEE FAMILY HEALTH CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 36D2009193

Address:
225 CARLTON DAVIDSON LN
COAL GROVE, OH
ZIP 45638
Phone: (740) 533-6280
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SHAWNEE MENTAL HEALTH CENTER, INC. is a federally qualified health center (fqhc) clinic center in Coal Grove, OH. SHAWNEE MENTAL HEALTH CENTER, INC. NPI is 1225508195. The provider is registered as an organization entity type.
The provider Is Doing Business As Dba Shawnee Family Health Center.

The provider's business location address is:

225 CARLTON DAVIDSON LN
COAL GROVE, OH
ZIP 45638-924
Phone: (740) 533-6280
Fax: (740) 353-1662

The provider's authorized official is Cynthia Holstein .
The authorized official title is Ceo and has the following contact phone number (740) 355-8686.

The CLIA number assigned to this NPI record is 36D2009193 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/4/2018 and was last updated on 5/9/2022.

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	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			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	0339264	MEDICAID	OHIO

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: 4/28/2024

NPI Synchronization or Removal

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