Provider Demographics
NPI:1306026539
Name:COMPREHENSIVE MENTAL HEALTH, INC
Entity Type:Organization
Organization Name:COMPREHENSIVE MENTAL HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JO
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BOOTH
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:636-949-2650
Mailing Address - Street 1:200 S KINGSHIGHWAY ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-1637
Mailing Address - Country:US
Mailing Address - Phone:636-949-2650
Mailing Address - Fax:696-949-2650
Practice Address - Street 1:200 S KINGSHIGHWAY ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-1637
Practice Address - Country:US
Practice Address - Phone:636-949-2650
Practice Address - Fax:696-949-2650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-05
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0046351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty