Provider Demographics
NPI:1922469618
Name:ANDERSON COUNTY MENTAL HEALTH
Entity Type:Organization
Organization Name:ANDERSON COUNTY MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:NUTT
Authorized Official - Suffix:
Authorized Official - Credentials:LSCSW, LAC
Authorized Official - Phone:785-204-4357
Mailing Address - Street 1:200 S MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:GARNETT
Mailing Address - State:KS
Mailing Address - Zip Code:66032-1017
Mailing Address - Country:US
Mailing Address - Phone:785-204-4357
Mailing Address - Fax:
Practice Address - Street 1:200 S MAPLE ST
Practice Address - Street 2:
Practice Address - City:GARNETT
Practice Address - State:KS
Practice Address - Zip Code:66032-1017
Practice Address - Country:US
Practice Address - Phone:785-204-4357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-09
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty