Provider Demographics
NPI:1922622471
Name:ALLIED MENTAL HEALTH LLC
Entity Type:Organization
Organization Name:ALLIED MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:
Authorized Official - Last Name:NEVINS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:715-808-0795
Mailing Address - Street 1:1334 HOSFORD ST STE B
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:WI
Mailing Address - Zip Code:54016-9230
Mailing Address - Country:US
Mailing Address - Phone:715-808-0795
Mailing Address - Fax:
Practice Address - Street 1:1334 HOSFORD ST STE B
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-9230
Practice Address - Country:US
Practice Address - Phone:715-808-0795
Practice Address - Fax:715-808-0361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-01
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty