The Mental Bistro, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

THE MENTAL BISTRO, LLC

Practice address

6595 Highway 43 BLDG D
Spruce Pine, AL 35585-4223

Phone

(256) 436-7460

NPI assigned

Aug 23, 2024

Last updated

Aug 23, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ashley Kimbrough, LICSW-S;PIPNPI 1851850309

Title

Therapist/Owner

Phone

(256) 436-7460

Specialties & licenses 1

Addresses

Locations

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.

• Ashley Kimbrough, LICSW-S;PIP

  • Clinical Social Worker
  • Decatur, AL
  • NPI 1851850309
  NPD Authorized official

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

{
    "created_epoch": "1724371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724371200000",
    "number": "1649003716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6595 HIGHWAY 43 BLDG D",
            "city": "SPRUCE PINE",
            "state": "AL",
            "postal_code": "355854223",
            "telephone_number": "256-436-7460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6595 HIGHWAY 43 BLDG D",
            "city": "SPRUCE PINE",
            "state": "AL",
            "postal_code": "355854223",
            "telephone_number": "256-436-7460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MENTAL BISTRO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-23",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A",
        "authorized_official_last_name": "KIMBROUGH",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "THERAPIST/OWNER",
        "authorized_official_telephone_number": "256-436-7460",
        "authorized_official_credential": "LICSW-S;PIP"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meagen Alyce Glasgow

• Clinical Social Worker in Spruce Pine, AL
• Providers in Spruce Pine, AL by specialty
• Clinical Social Worker in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; 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.