Northwest Alabama Mental Health Center
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Jasper, AL
NPI 1295829489 · NPPES record last updated Oct 17, 2011
Key facts
- NPI
- 1295829489
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- NORTHWEST ALABAMA MENTAL HEALTH CENTER
- Practice address
- 1100 7TH Ave
Jasper, AL 35501-4377 - Phone
- (205) 302-9000
- Fax
- (205) 387-8270
- NPI assigned
- Oct 3, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Floyd Fulton Newman Jr., MSW
- Title
- Executive Director
- Phone
- (205) 302-9065
Other NPIs on the same Medicare enrollment 1
Corporate family (same tax ID) 3
Practitioners 12
-
Belynda Jo Adams, CRNP
-
Syed R Aftab, MD
-
Mary Lucian L Cronkite, LCSW
-
Ashley Shante Davis, PMHNP-BC
-
Nancy R Kennedy, LPC
-
Martha Annalee Rubley, LICSW
-
Paula J Sweet, CRNP
-
Farrukh Jamil, MD
-
Masood Khan, MD
-
Clyde McLane III, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040128001049 | AL | Part B Supplier - Clinic/Group Practice | 0749181998 |
Receives reassigned benefits from 12 practitioners 1 other NPI on this enrollment Practice locations: Jasper, AL; Vernon, AL; Hamilton, AL; Haleyville, AL; Fayette, AL |
National Provider Directory
- Tax ID family
- Northwest Alabama Mental Health Center
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes |
Addresses
Primary practice location
1100 7TH Ave
Jasper, AL 35501-4377
Mailing address
1100 7TH Ave
Jasper, AL 35501-4377
Phone (205) 302-9000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 330000015 | Medicaid | AL | |
| 590000015 | Medicaid | AL | |
| 330034015 | Medicaid | AL |
Other providers in Jasper, AL
- Kayela Norris
- Leah Norris
- Northland Hearing Centers, Inc.
- Northwest Alabama Mental Health Center
- Northwest Alabama Mental Health Center
- Northwest Alabama Mental Health Center
- Northwest Alabama Mental Health Center
- Northwest Alabama Mental Health Center
- Northwest Alabama Psychiatric Services
- Northwest Alabama Psychiatric Services
All providers in Jasper, AL · Mental Health Clinic/Center (Including Community Mental Health Center) in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.