NPIMap

Organization Active NPI

Mental Health Center of North Central Alabama Inc.

  • Community/Behavioral Health Agency
  • Decatur, AL
National Provider Identifier
1124193636
Registry record updated Oct 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MENTAL HEALTH CENTER OF NORTH CENTRAL ALABAMA INC.
Practice address
4110 US Highway 31 S
Decatur, AL 35603-1644
Phone
(256) 355-6105
NPI assigned
Nov 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2016

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

Authorized official

Name
Ms. Lisa S Coleman, LCSW
Title
Executive Director
Phone
(256) 260-7330

Specialties & licenses 1

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

Addresses

Primary practice location

4110 US Highway 31 S
Decatur, AL 35603-1644

Mailing address

1316 Somerville Rd SE
Suite 1
Decatur, AL 35601-4309
Phone (256) 355-6105

Other identifiers 5

IdentifierTypeStateIssuer
51009252OtherALBLUE CROSS BLUE SHIELD OF ALABAMA
590000008MedicaidAL
51008101OtherALBLUE CROSS BLUE SHIELD OF ALABAMA
330034008MedicaidAL
330000008MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040203000415 AL Part B Supplier - Clinic/Group Practice 9436042645 Receives reassigned benefits from 11 practitioners
Practice locations: Athens, AL; Decatur, AL; Moulton, AL

National Provider Directory

National Provider Directory
Tax ID family
Mental HLTH Ctrquest2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1307 E Elm St
Athens, AL 35611
Phone (256) 232-3661

1315 13th Ave SE
Decatur, AL 35601
Phone (256) 260-7306

295 Hospital St
Moulton, AL 35650
Phone (256) 974-6697

317 Hospital St
Moulton, AL 35650
Phone (256) 355-6091

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 336

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

View all 336

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475452800000",
    "number": "1124193636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 SOMERVILLE RD SE",
            "address_2": "SUITE 1",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356014309",
            "telephone_number": "256-355-6105",
            "fax_number": "256-341-0747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 US HIGHWAY 31 S",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356031644",
            "telephone_number": "256-355-6105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL HEALTH CENTER OF NORTH CENTRAL ALABAMA INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2016-10-03",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "256-260-7330",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF ALABAMA",
            "identifier": "51009252",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "590000008",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF ALABAMA",
            "identifier": "51008101",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "330034008",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "330000008",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.