NPIMap

Organization Active NPI

Duncanville Mental Health Services

  • Community/Behavioral Health Agency
  • Dallas, TX
National Provider Identifier
1710474077
Registry record updated Aug 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
DUNCANVILLE MENTAL HEALTH SERVICES
Practice address
4333 Gannon LN Ste 101
Dallas, TX 75237-4222
Phone
(972) 283-9090
Fax
(972) 499-0637
NPI assigned
Apr 21, 2018
Last updated
Aug 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2018

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

Authorized official

Name
Kenneth R Medlock
Title
Chief Executive Officer
Phone
(469) 879-8328

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NU
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Adult Mental Health Clinic/Center 261QM0850X NU
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU
Multi-Specialty Clinic/Center 261QM1300X NU
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

4333 Gannon LN Ste 101
Dallas, TX 75237-4222

Mailing address

150 E Highway 67 Ste 204
Duncanville, TX 75137-4481
Phone (469) 879-8328

National Provider Directory

National Provider Directory

Locations

150 E Highway 67
Ste 204
Duncanville, TX 75137
Phone (781) 591-7472

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1524268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1710474077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 E HIGHWAY 67 STE 204",
            "city": "DUNCANVILLE",
            "state": "TX",
            "postal_code": "751374481",
            "telephone_number": "469-879-8328",
            "fax_number": "469-916-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4333 GANNON LN STE 101",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752374222",
            "telephone_number": "972-283-9090",
            "fax_number": "972-499-0637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUNCANVILLE MENTAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-21",
        "last_updated": "2018-08-17",
        "status": "A",
        "authorized_official_last_name": "MEDLOCK",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "469-879-8328"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; 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.