Provider Demographics
NPI:1396876157
Name:MENTAL HEALTH ASSOCIATION OF OKALOOSA & WALTON COUNTIES, INC.
Entity type:Organization
Organization Name:MENTAL HEALTH ASSOCIATION OF OKALOOSA & WALTON COUNTIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:GLYNN
Authorized Official - Last Name:BARR
Authorized Official - Suffix:
Authorized Official - Credentials:ACSW
Authorized Official - Phone:850-244-1040
Mailing Address - Street 1:571 MOONEY RD NE
Mailing Address - Street 2:
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32547-1859
Mailing Address - Country:US
Mailing Address - Phone:850-244-1040
Mailing Address - Fax:850-244-2573
Practice Address - Street 1:571 MOONEY RD NE
Practice Address - Street 2:
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32547-1859
Practice Address - Country:US
Practice Address - Phone:850-244-1040
Practice Address - Fax:850-244-2573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable