Provider Demographics
NPI:1336343292
Name:MENTAL HEALTH ASSOCIATES
Entity Type:Organization
Organization Name:MENTAL HEALTH ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:CARMER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:402-435-1313
Mailing Address - Street 1:650 J ST
Mailing Address - Street 2:SUITE 403
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68508-2900
Mailing Address - Country:US
Mailing Address - Phone:402-435-1313
Mailing Address - Fax:402-435-5056
Practice Address - Street 1:650 J ST
Practice Address - Street 2:SUITE 403
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68508-2900
Practice Address - Country:US
Practice Address - Phone:402-435-1313
Practice Address - Fax:402-435-5056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1704101YM0800X
NE7585101YM0800X
NE7110101YM0800X
NE1413101YM0800X
NE217103TC0700X
NE517103TC0700X
NE1140106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========26Medicaid
NE=========26MedicaidPROVIDER NUMBER
NE=========26MedicaidPROVIDER NUMBER