Provider Demographics
NPI:1871576835
Name:COLLIN COUNTY MENTAL HEALTH MENTAL RETARDATION CENTER
Entity type:Organization
Organization Name:COLLIN COUNTY MENTAL HEALTH MENTAL RETARDATION CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:SHEELA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTONY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-963-3655
Mailing Address - Street 1:1515 HERITAGE DR STE 105
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-3378
Mailing Address - Country:US
Mailing Address - Phone:972-562-0190
Mailing Address - Fax:972-562-3647
Practice Address - Street 1:1515 HERITAGE DR
Practice Address - Street 2:105
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-3256
Practice Address - Country:US
Practice Address - Phone:972-562-0190
Practice Address - Fax:972-665-0076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-23
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X, 106H00000X, 2084P0800X, 2084P0804X, 225100000X, 225X00000X, 235Z00000X, 320600000X, 101Y00000X, 101YM0800X, 101YP2500X
TX251B00000X, 261QD1600X, 261QM0801X
TX3274 -3276261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental DisabilitiesGroup - Multi-Specialty
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use DisorderGroup - Multi-Specialty
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX127377301Medicaid
TX127377302Medicaid
TX127377304Medicaid
TX127377306Medicaid
TX001007092OtherHCS
TX127377305Medicaid
TX001010100OtherTXHML
TXGR410OtherGR-SERVICE COORDINATION
TX084001901Medicaid
TX000730601OtherICF-MR-MULLINS
TX00726901OtherICF-MR-CROSS BEND
TX127377304Medicaid