NPIMap

Organization Active NPI

Magnolia Mental Health Services

  • Psychiatric/Mental Health Nurse Practitioner
  • Baton Rouge, LA
National Provider Identifier
1316513559
Registry record updated Sep 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MAGNOLIA MENTAL HEALTH SERVICES
Practice address
11764 Haymarket Ave
Baton Rouge, LA 70816-6009
Phone
(225) 773-0942
NPI assigned
May 28, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2021

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

Authorized official

Name
Tonya Greene Stelly, RN,MSM,PMHNP-BCNPI 1972183739
Title
Nurse Practitioner
Phone
(225) 773-0942

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
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

11764 Haymarket Ave
Baton Rouge, LA 70816-6009

Mailing address

13170 Dutchtown Point Ave Apt 1421
Gonzales, LA 70737-0105
Phone (225) 773-0942

Other identifiers 1

IdentifierTypeStateIssuer
1316513559MedicaidLA

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL GONZALES Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

11764 Haymarket Ave
Baton Rouge, LA 70816
Phone (225) 256-5200

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": "1622160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632528000000",
    "number": "1316513559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13170 DUTCHTOWN POINT AVE APT 1421",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707370105",
            "telephone_number": "225-773-0942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11764 HAYMARKET AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166009",
            "telephone_number": "225-773-0942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA MENTAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-28",
        "last_updated": "2021-09-25",
        "certification_date": "2021-09-25",
        "status": "A",
        "authorized_official_last_name": "STELLY",
        "authorized_official_first_name": "TONYA",
        "authorized_official_middle_name": "GREENE",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "225-773-0942",
        "authorized_official_credential": "RN,MSM,PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316513559",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "GONZALES",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "13170 Dutchtown Point Ave Apt 1421",
            "city": "Gonzales",
            "state": "LA",
            "country_code": "US",
            "postal_code": "707370105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2021; 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.