Organization Active NPI

Mental Health Soldier, LLC

  • Psychiatry Physician
  • Gahanna, OH
National Provider Identifier
1679172035
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
MENTAL HEALTH SOLDIER, LLC
Doing business as
Mental Health Soldier, LLC
Practice address
543 Gayle Dr
Gahanna, OH 43230-2886
Phone
(216) 972-4033
NPI assigned
Oct 18, 2020
Last updated
Sep 29, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Authorized official

Name
Alenna Jones Mba Pmhnp-BC, PMHNP-BC
Title
Ceo
Phone
(216) 972-4033

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

543 Gayle Dr
Gahanna, OH 43230-2886

Mailing address

543 Gayle Dr
Gahanna, OH 43230-2886
Phone (216) 972-4033

Other names 1

  • Mental Health Soldier, LLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210120002805 OH Part B Supplier - Clinic/Group Practice 6901210632 Receives reassigned benefits from 1 practitioner
Practice locations: Gahanna, OH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1602979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695945600000",
    "number": "1679172035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "543 GAYLE DR",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432302886",
            "telephone_number": "216-972-4033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "543 GAYLE DR",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432302886",
            "telephone_number": "216-972-4033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL HEALTH SOLDIER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-18",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A",
        "authorized_official_last_name": "PMHNP-BC",
        "authorized_official_first_name": "ALENNA JONES",
        "authorized_official_middle_name": "MBA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "216-972-4033",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mental Health Soldier, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mental Health Soldier, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gahanna, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; 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.