Provider Demographics
NPI:1386041192
Name:MENTAL HEALTH PROFESSIONAL SOLUTIONS, INC.
Entity Type:Organization
Organization Name:MENTAL HEALTH PROFESSIONAL SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:GOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-848-1222
Mailing Address - Street 1:2565 W 79TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60652-1729
Mailing Address - Country:US
Mailing Address - Phone:773-848-1222
Mailing Address - Fax:773-737-0401
Practice Address - Street 1:2565 W 79TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60652-1729
Practice Address - Country:US
Practice Address - Phone:773-848-1222
Practice Address - Fax:773-737-0401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-21
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health