Provider Demographics
NPI:1184596488
Name:TALBERT MENTAL HEALTH LLC
Entity type:Organization
Organization Name:TALBERT MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:TALBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-873-5552
Mailing Address - Street 1:2848 MEMORIAL DR STE 11
Mailing Address - Street 2:
Mailing Address - City:TWO RIVERS
Mailing Address - State:WI
Mailing Address - Zip Code:54241-3639
Mailing Address - Country:US
Mailing Address - Phone:920-873-5552
Mailing Address - Fax:920-873-5533
Practice Address - Street 1:2848 MEMORIAL DR STE 11
Practice Address - Street 2:
Practice Address - City:TWO RIVERS
Practice Address - State:WI
Practice Address - Zip Code:54241-3639
Practice Address - Country:US
Practice Address - Phone:920-873-5552
Practice Address - Fax:920-873-5533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-18
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty