Mental Wellness Inc

Primary specialty

Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X

License

70000195A Issued in IN

Legal business name

MENTAL WELLNESS INC

Doing business as

Westside Mental Health

Practice address

192 N Avon Ave
Suite 300
Avon, IN 46123-9513

Phone

(317) 672-6400

Fax

(317) 672-6401

NPI assigned

Mar 10, 2016

Last updated

Apr 1, 2016By 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

Mrs. Tammy Jo Coomer Bradford, CNS, APRN-BC

Title

President

Phone

(507) 779-4795

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Westside Mental Health Doing business as

Locations

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

{
    "created_epoch": "1457568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459468800000",
    "number": "1811358492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 N AVON AVE",
            "address_2": "SUITE 300",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461239513",
            "telephone_number": "317-672-6400",
            "fax_number": "317-672-6401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "192 N AVON AVE",
            "address_2": "SUITE 300",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461239513",
            "telephone_number": "317-672-6400",
            "fax_number": "317-672-6401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL WELLNESS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-10",
        "last_updated": "2016-04-01",
        "status": "A",
        "authorized_official_last_name": "BRADFORD",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "JO COOMER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "507-779-4795",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CNS, APRN-BC"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "IN",
            "license": "70000195A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NPI",
            "identifier": "1730265356",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200285820",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Westside Mental Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katherine Brown Meisberger, PHARMD
• Casey Meldgin, MSW
• Theresa Kay Menner, NP
• Antoinette A Mensah, MD
• Mental Health America of Hendricks County
• Meridian Medical Group PC
• Reagan Merrill
• Holli Merritt, RBT
• Michaela Mershon, RPH
• Kimberly K Metro

• Psychiatric/Mental Health Clinical Nurse Specialist in Avon, IN
• Providers in Avon, IN by specialty
• Psychiatric/Mental Health Clinical Nurse Specialist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2016; 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.