Provider Demographics
NPI:1679172035
Name:MENTAL HEALTH SOLDIER, LLC
Entity Type:Organization
Organization Name:MENTAL HEALTH SOLDIER, LLC
Other - Org Name:MENTAL HEALTH SOLDIER, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALENNA JONES
Authorized Official - Middle Name:MBA
Authorized Official - Last Name:PMHNP-BC
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:216-972-4033
Mailing Address - Street 1:543 GAYLE DR
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-2886
Mailing Address - Country:US
Mailing Address - Phone:216-972-4033
Mailing Address - Fax:
Practice Address - Street 1:543 GAYLE DR
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-2886
Practice Address - Country:US
Practice Address - Phone:216-972-4033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-18
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty