Provider Demographics
NPI:1073634242
Name:THE MENTAL HEALTH ASSOCIATION IN NORTH CAROLINA, INC.
Entity Type:Organization
Organization Name:THE MENTAL HEALTH ASSOCIATION IN NORTH CAROLINA, INC.
Other - Org Name:UNION PSR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCIAL ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:COCHRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-866-3287
Mailing Address - Street 1:1331 SUNDAY DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-5166
Mailing Address - Country:US
Mailing Address - Phone:919-866-3287
Mailing Address - Fax:
Practice Address - Street 1:316 W ALLEN ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-3169
Practice Address - Country:US
Practice Address - Phone:704-283-5128
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-090-035251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health