NPIMap

Organization Active NPI

Southwest Alabama Mental Health/Mental Retardation Inc.

  • Community/Behavioral Health Agency
  • Grove Hill, AL
National Provider Identifier
1104014554
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
L258 Issued in AL
Legal business name
SOUTHWEST ALABAMA MENTAL HEALTH/MENTAL RETARDATION INC.
Practice address
129 Clark St
Grove Hill, AL 36451-3050
Phone
(251) 275-4165
NPI assigned
Oct 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Michael Wayne Goldman, M.A.
Title
LMFT/ Coordinator Clarke County
Phone
(251) 275-4165

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X L258 AL Primary

Addresses

Primary practice location

129 Clark St
Grove Hill, AL 36451-3050

Mailing address

129 Clark St
Grove Hill, AL 36451-3050

National Provider Directory

National Provider Directory
Tax ID family
Southwest Alabama Mental Health5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

129 Clark St
Grove Hill, AL 36451
Phone (251) 275-4165

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 27

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192060800000",
    "number": "1104014554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 CLARK ST",
            "city": "GROVE HILL",
            "state": "AL",
            "postal_code": "364513050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 CLARK ST",
            "city": "GROVE HILL",
            "state": "AL",
            "postal_code": "364513050",
            "telephone_number": "251-275-4165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST ALABAMA MENTAL HEALTH/MENTAL RETARDATION INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-11",
        "last_updated": "2007-10-11",
        "status": "A",
        "authorized_official_last_name": "GOLDMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "LMFT/ COORDINATOR CLARKE COUNTY",
        "authorized_official_telephone_number": "251-275-4165",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.A."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AL",
            "license": "L258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grove Hill, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.