Provider Demographics
NPI:1316589385
Name:MENTAL HEALTH PLUS LLC
Entity Type:Organization
Organization Name:MENTAL HEALTH PLUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARINELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRAUD
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-FNP
Authorized Official - Phone:978-720-8934
Mailing Address - Street 1:100 CUMMINGS CTR STE 325K
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-6119
Mailing Address - Country:US
Mailing Address - Phone:978-720-8934
Mailing Address - Fax:978-969-6198
Practice Address - Street 1:100 CUMMINGS CTR STE 325K
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-6119
Practice Address - Country:US
Practice Address - Phone:617-838-0254
Practice Address - Fax:978-969-6198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-11
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1528461340Medicaid