NPIMap

Organization Active NPI

Four County Comprehensive Mental Health Center, Inc

Doing business as Four County Counseling Center

  • Clinic/Center
  • Logansport, IN
National Provider Identifier
1184052102
Registry record updated Oct 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
71004557A Issued in IN
Legal business name
FOUR COUNTY COMPREHENSIVE MENTAL HEALTH CENTER, INC
Doing business as
Four County Counseling Center
Practice address
1015 Michigan Ave
Logansport, IN 46947-1526
Phone
(574) 732-2468
Fax
(574) 739-1414
NPI assigned
Oct 30, 2013
Last updated
Oct 30, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2013

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

Authorized official

Name
Mrs. Stacy Lynn Williams, MBANPI 1497921472
Title
Director of Business Operations
Phone
(574) 732-2468

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 71004557A IN Primary

Addresses

Primary practice location

1015 Michigan Ave
Logansport, IN 46947-1526

Mailing address

1015 Michigan Ave
Logansport, IN 46947-1526
Phone (574) 732-2468

Other names 1

  • Four County Counseling Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Four County Mental HLTH Ctr4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1383091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383091200000",
    "number": "1184052102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 MICHIGAN AVE",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469471526",
            "telephone_number": "574-732-2468",
            "fax_number": "574-739-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 MICHIGAN AVE",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469471526",
            "telephone_number": "574-732-2468",
            "fax_number": "574-739-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR COUNTY COMPREHENSIVE MENTAL HEALTH CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-30",
        "last_updated": "2013-10-30",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS OPERATIONS",
        "authorized_official_telephone_number": "574-732-2468",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IN",
            "license": "71004557A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Four County Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Logansport, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2013; 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.