NPIMap

Organization Active NPI

Shawnee Mental Health Center, Inc.

Doing business as Shawnee Family Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portsmouth, OH
National Provider Identifier
1336173236
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
0308 Issued in OH
Legal business name
SHAWNEE MENTAL HEALTH CENTER, INC.
Doing business as
Shawnee Family Health Center
Practice address
901 Washington St
Portsmouth, OH 45662-3944
Phone
(740) 354-7702
Fax
(740) 353-1662
NPI assigned
Jul 10, 2006
Last updated
May 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Authorized official

Name
Cynthia Holstein
Title
Ceo
Phone
(740) 355-8686

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 0308 OH Primary

Addresses

Primary practice location

901 Washington St
Portsmouth, OH 45662-3944

Mailing address

901 Washington St
Portsmouth, OH 45662-3944
Phone (740) 354-7702

Other identifiers 1

IdentifierTypeStateIssuer
0200599MedicaidOH

Other names 1

  • Shawnee Family Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040419000643 OH Part B Supplier - Clinic/Group Practice 7012902075 Receives reassigned benefits from 48 practitioners
2 other NPIs on this enrollment
Practice locations: Portsmouth, OH; West Union, OH; Coal Grove, OH

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Shawnee Mental Health Center Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

225 Carlton Davidson Ln
Coal Grove, OH 45638
Phone (740) 354-7702

2203 25th St
Portsmouth, OH 45662
Phone (740) 354-7702

Practitioners & affiliated clinicians

Practitioners 80

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.

View all 80

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651708800000",
    "number": "1336173236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 WASHINGTON ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456623944",
            "telephone_number": "740-354-7702",
            "fax_number": "740-353-1662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 WASHINGTON ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456623944",
            "telephone_number": "740-354-7702",
            "fax_number": "740-353-1662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAWNEE MENTAL HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A",
        "authorized_official_last_name": "HOLSTEIN",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "740-355-8686"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "OH",
            "license": "0308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0200599",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shawnee Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portsmouth, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; 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.