NPIMap

Organization Active NPI

Mohave Mental Health Clinic, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Bullhead City, AZ
National Provider Identifier
1619294865
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
License
OTC5983 Issued in AZ
Legal business name
MOHAVE MENTAL HEALTH CLINIC, INC.
Practice address
2580 Highway 95
Suite 209
Bullhead City, AZ 86442-7491
Phone
(928) 757-8111
Fax
(928) 758-1458
NPI assigned
Apr 28, 2010
Last updated
Jun 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Authorized official

Name
Dawn D Abbott, MA, LPCNPI 1184612442
Title
Chief Executive Officer
Phone
(928) 757-8111

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X BH-3551 AZ
Adolescent and Children Mental Health Clinic/Center 261QM0855X OTC5983 AZ Primary

Addresses

Primary practice location

2580 Highway 95
Suite 209
Bullhead City, AZ 86442-7491

Mailing address

3707 N Stockton Hill Rd Ste B
Kingman, AZ 86409-0507
Phone (928) 757-8111

National Provider Directory

National Provider Directory
Tax ID family
Mohave Mental Healt8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Practitioners & affiliated clinicians

Practitioners 8

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": "1272412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624406400000",
    "number": "1619294865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3707 N STOCKTON HILL RD STE B",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864090507",
            "telephone_number": "928-757-8111",
            "fax_number": "928-757-3256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2580 HIGHWAY 95",
            "address_2": "SUITE 209",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864427491",
            "telephone_number": "928-757-8111",
            "fax_number": "928-758-1458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOHAVE MENTAL HEALTH CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-28",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A",
        "authorized_official_last_name": "ABBOTT",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "928-757-8111",
        "authorized_official_credential": "MA, LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "AZ",
            "license": "BH-3551",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "AZ",
            "license": "OTC5983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bullhead City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.