Provider Demographics
NPI:1649048406
Name:SOUTHERN INDIANA MENTAL HEALTH CLINIC CORP
Entity type:Organization
Organization Name:SOUTHERN INDIANA MENTAL HEALTH CLINIC CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:AKIN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:812-515-3160
Mailing Address - Street 1:113 N CHESTNUT ST STE 301
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:IN
Mailing Address - Zip Code:47274-2197
Mailing Address - Country:US
Mailing Address - Phone:812-515-3160
Mailing Address - Fax:
Practice Address - Street 1:113 N CHESTNUT ST STE 301
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:IN
Practice Address - Zip Code:47274-2197
Practice Address - Country:US
Practice Address - Phone:812-515-3160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-12
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty