Provider Demographics
NPI:1932505138
Name:ALLIED MENTAL HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:ALLIED MENTAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:PHD,LMHC, LPC
Authorized Official - Phone:917-364-3785
Mailing Address - Street 1:1331 AIRPORT DR
Mailing Address - Street 2:G17
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32304-4775
Mailing Address - Country:US
Mailing Address - Phone:917-364-3785
Mailing Address - Fax:
Practice Address - Street 1:40 CLINTON ST
Practice Address - Street 2:STE L
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-9713
Practice Address - Country:US
Practice Address - Phone:917-364-3785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-15
Last Update Date:2014-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 11779251S00000X
NJ37PC00510200251S00000X, 252Y00000X
FLMH11779252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251S00000XAgenciesCommunity/Behavioral Health