Provider Demographics
NPI:1649630476
Name:DMH MENTAL HEALTH CONSULTATION AND TRAINING LLC
Entity type:Organization
Organization Name:DMH MENTAL HEALTH CONSULTATION AND TRAINING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MR
Authorized Official - First Name:DELVIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HECTOR
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:904-610-2039
Mailing Address - Street 1:6050 DONALD GUY RD
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:32539-9718
Mailing Address - Country:US
Mailing Address - Phone:513-657-1541
Mailing Address - Fax:
Practice Address - Street 1:6050 DONALD GUY RD
Practice Address - Street 2:
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32539-9718
Practice Address - Country:US
Practice Address - Phone:513-657-1541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-07
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty