Mmo of Covington, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

194701 Issued in LA

Legal business name

MMO OF COVINGTON, LLC

Practice address

201 Greenbriar Blvd
Covington, LA 70433-7236

Phone

(985) 249-7780

Fax

(985) 249-7782

NPI assigned

May 26, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Robert L. Miller

Title

Executive Officer

Phone

(225) 293-6774

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• North Lake Community Mental Health, LLC Former legal business name

Locations

Practitioners 2

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

• Lovell M Cahill, LCSW

  • Clinical Social Worker
  • Covington, LA
  • NPI 1164548251
  NPD (past)
• Celeste A Graham

  • Clinical Social Worker
  • Covington, LA
  • NPI 1073600821
  NPD (past)

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278028800000",
    "number": "1669428140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 NORTH BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708025724",
            "telephone_number": "225-293-6774",
            "fax_number": "225-291-9229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 GREENBRIAR BLVD",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704337236",
            "telephone_number": "985-249-7780",
            "fax_number": "985-249-7782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MMO OF COVINGTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2010-07-02",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "225-293-6774",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "LA",
            "license": "194701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL LICENSE",
            "identifier": "8303",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Lake Community Mental Health, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Sarah Mitchell, DPT
• Thomas Mitchell, LPC, NCC
• Stephen G Mixon, NP
• Whitney Mixon, MS,LPC,NCC
• Edward Kevin Mizell, PT
• Mobility Solutions Inc
• Mobility Solutions Inc
• Stephen Windsor Mock, CSW
• Daniel P. Mokry
• Christa Lynn Moliniare-Martin, APRN FNP

• Mental Health Clinic/Center (Including Community Mental Health Center) in Covington, LA
• Providers in Covington, LA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2010; 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.