NPIMap

Organization Active NPI

Mono County Behavioral Health

  • Community/Behavioral Health Agency
  • Mammoth Lakes, CA
National Provider Identifier
1861050643
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MONO COUNTY BEHAVIORAL HEALTH
Practice address
1290 Tavern Road
Mammoth Lakes, CA 93546
Phone
(760) 924-1740
Fax
(760) 924-1741
NPI assigned
Jun 5, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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

Authorized official

Name
Ms. Robin K Roberts, MFT
Title
Director of Behavioral Health
Phone
(760) 924-1729

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1290 Tavern Road
Mammoth Lakes, CA 93546

Mailing address

PO Box 2619
Mammoth Lakes, CA 93546-2619
Phone (760) 924-1740

Other identifiers 1

IdentifierTypeStateIssuer
2601MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
County of Mono6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1290 Tavern Rd
Mammoth Lakes, CA 93546
Phone (760) 924-1740

Practitioners & affiliated clinicians

Practitioners 45

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

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660780800000",
    "number": "1861050643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2619",
            "city": "MAMMOTH LAKES",
            "state": "CA",
            "postal_code": "935462619",
            "telephone_number": "760-924-1740",
            "fax_number": "760-924-1741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 TAVERN ROAD",
            "city": "MAMMOTH LAKES",
            "state": "CA",
            "postal_code": "93546",
            "telephone_number": "760-924-1740",
            "fax_number": "760-924-1741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONO COUNTY BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-05",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "DIRECTOR OF BEHAVIORAL HEALTH",
        "authorized_official_telephone_number": "760-924-1729",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MFT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2601",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mammoth Lakes, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; 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.