Provider Demographics
NPI:1922777549
Name:MENTAL HEALTH PRIORITY MHP
Entity Type:Organization
Organization Name:MENTAL HEALTH PRIORITY MHP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:N
Authorized Official - Last Name:MOTON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:337-391-1860
Mailing Address - Street 1:4235 PINE SHADOWS LN
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70615-2992
Mailing Address - Country:US
Mailing Address - Phone:337-391-1860
Mailing Address - Fax:
Practice Address - Street 1:7740 COHENOUR RD
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:TX
Practice Address - Zip Code:77632-5969
Practice Address - Country:US
Practice Address - Phone:337-704-6930
Practice Address - Fax:225-282-1010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-08
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No251B00000XAgenciesCase ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2528564Medicaid