NPIMap

Organization Active NPI

Mohave Mental Health Clinic Inc

  • Psychiatric Hospital Unit
  • Kingman, AZ
National Provider Identifier
1952471518
Registry record updated Mar 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
IFBH6611 Issued in AZ
Legal business name
MOHAVE MENTAL HEALTH CLINIC INC
Practice address
1741 Sycamore Avenue
Kingman, AZ 86409
Phone
(928) 757-8111
Fax
(928) 757-7872
NPI assigned
Nov 9, 2006
Last updated
Mar 30, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2016

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

Authorized official

Name
Ms. Dawn D Abbott, MA ABHMNPI 1184612442
Title
Chief Executive Officer
Phone
(928) 757-8111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X BH1940 AZ
Psychiatric Hospital Unit 273R00000X IFBH6611 AZ Primary

Addresses

Primary practice location

1741 Sycamore Avenue
Kingman, AZ 86409

Mailing address

1743 Sycamore Avenue
Kingman, AZ 86409
Phone (928) 757-8111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040422000707 AZ Part B Supplier - Clinic/Group Practice 7618963935 Receives reassigned benefits from 17 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bullhead City, AZ; Kingman, AZ; Lake Havasu City, AZ

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D0961663Mohave Mental Health Clinic Inc1741 Sycamore Ave, Kingman, AZ 86409Certificate of waiverJun 13, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459296000000",
    "number": "1952471518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1743 SYCAMORE AVENUE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "86409",
            "telephone_number": "928-757-8111",
            "fax_number": "928-757-3256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1741 SYCAMORE AVENUE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "86409",
            "telephone_number": "928-757-8111",
            "fax_number": "928-757-7872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOHAVE MENTAL HEALTH CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2016-03-30",
        "status": "A",
        "authorized_official_last_name": "ABBOTT",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "928-757-8111",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA ABHM"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "AZ",
            "license": "BH1940",
            "primary": false
        },
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "AZ",
            "license": "IFBH6611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingman, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.