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GENESEE COUNTY COMMUNITY MENTAL HEALTH NPI 1912225111


NPI Information

NPI: 1912225111
Provider Name: GENESEE COUNTY COMMUNITY MENTAL HEALTH
Classification: Psychologist - 103TH0100X
Entity Type: Organization

Specialization: Health Service

Address:
420 W 5TH AVE
FLINT, MI
ZIP 48503
Phone: (810) 257-3736
Get Directions

GENESEE COUNTY COMMUNITY MENTAL HEALTH is a health service psychologist in Flint, MI. The provider is a psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974). GENESEE COUNTY COMMUNITY MENTAL HEALTH NPI is 1912225111. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

420 W 5TH AVE
FLINT, MI
ZIP 48503-445
Phone: (810) 257-3736

The provider's authorized official is Danis Russell .
The authorized official title is Chief Executive Officer and has the following contact phone number (810) 257-3707.

The enumeration date for this NPI number is 5/12/2010 and was last updated on 5/12/2010.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TH0100XPsychologistHealth ServiceYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1774350384MEDICAIDMICHIGAN

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

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