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MENTAL HEALTH SERVICES FOR CLARK CO INC NPI 1982695706


NPI Information

NPI: 1982695706
Provider Name: MENTAL HEALTH SERVICES FOR CLARK CO INC

Doing Business As: MENTAL HEALTH SERVICES FOR CLARK AND MADISON COUNTIES, INC.

Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 36D1019043

Address:
474 N YELLOW SPRINGS STREET
SPRINGFIELD, OH
ZIP 45504
Phone: (937) 399-9500
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MENTAL HEALTH SERVICES FOR CLARK CO INC is a multi-specialty clinic center in Springfield, OH. MENTAL HEALTH SERVICES FOR CLARK CO INC NPI is 1982695706. The provider is registered as an organization entity type.
The provider Is Doing Business As Mental Health Services For Clark And Madison Counties, Inc..

The provider's business location address is:

474 N YELLOW SPRINGS STREET
SPRINGFIELD, OH
ZIP 45504-463
Phone: (937) 399-9500
Fax: (937) 342-4242

The provider's authorized official is Kelly L Rigger .
The authorized official title is Ceo and has the following contact phone number (937) 399-9500.

The CLIA number assigned to this NPI record is 36D1019043 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/1/2005 and was last updated on 5/11/2021.


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
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)No
2261QM0850XClinic/CenterAdult Mental HealthNo
3261QM0855XClinic/CenterAdolescent and Children Mental HealthNo
4261QM1300XClinic/CenterMulti-SpecialtyYes
5261QP2300XClinic/CenterPrimary CareNo
6261QR0405XClinic/CenterRehabilitation, Substance Use DisorderNo

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
19338511OTHEROHIOMEDICARE
20006OTHEROHIOOHIO DEPT OF MENTAL HEALT
32466602MEDICAIDOHIO

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.