Organization Active NPI

MBHC Inc

  • Mental Health Counselor
  • Perrysburg, OH
National Provider Identifier
1457548224
Registry record updated Sep 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
35057923 Issued in OH
Legal business name
MBHC INC
Practice address
27475 Holiday LN Ste 2
Perrysburg, OH 43551-3350
Phone
(419) 872-0619
Fax
(419) 872-2466
NPI assigned
Sep 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2007

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

Authorized official

Name
Dr. Charles S Burke, MDNPI 1164408175
Title
President
Phone
(419) 872-0619

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 35057923 OH Primary

Addresses

Primary practice location

27475 Holiday LN Ste 2
Perrysburg, OH 43551-3350

Mailing address

27475 Holiday LN Ste 2
Perrysburg, OH 43551-3350
Phone (419) 872-0619

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120224000119 OH Part B Supplier - Clinic/Group Practice 0345408191 Receives reassigned benefits from 1 practitioner
Practice locations: Perrysburg, OH

National Provider Directory

National Provider Directory

Locations

27475 Holiday Ln
Ste 2
Perrysburg, OH 43551
Phone (419) 872-0519

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190764800000",
    "number": "1457548224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27475 HOLIDAY LN STE 2",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435513350",
            "telephone_number": "419-872-0619",
            "fax_number": "419-872-2466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27475 HOLIDAY LN STE 2",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435513350",
            "telephone_number": "419-872-0619",
            "fax_number": "419-872-2466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MBHC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-26",
        "last_updated": "2007-09-26",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-872-0619",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "35057923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perrysburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2007; 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.