Provider Demographics
NPI:1710191028
Name:CC-MENTAL HEALTH ACCESS POINT
Entity Type:Organization
Organization Name:CC-MENTAL HEALTH ACCESS POINT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIAGNOSTIC ASSESSMENT SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICKIE
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:JELLISON
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:513-558-3422
Mailing Address - Street 1:310 CRESCENT AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45215-4407
Mailing Address - Country:US
Mailing Address - Phone:513-558-3422
Mailing Address - Fax:513-558-6745
Practice Address - Street 1:311 ALBERT SABIN WAY
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-2801
Practice Address - Country:US
Practice Address - Phone:513-558-3422
Practice Address - Fax:513-558-6745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health