Provider Demographics
NPI:1518850395
Name:MERCY BEHAVIORAL HEALTH PLLC
Entity type:Organization
Organization Name:MERCY BEHAVIORAL HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TINSAE
Authorized Official - Middle Name:
Authorized Official - Last Name:TOLLESA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-882-0570
Mailing Address - Street 1:378 BELL DR W
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37398-5404
Mailing Address - Country:US
Mailing Address - Phone:940-882-0570
Mailing Address - Fax:
Practice Address - Street 1:378 BELL DR W
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37398-5404
Practice Address - Country:US
Practice Address - Phone:940-882-0570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-31
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)