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NPI Code Detail

MEDICARE: ALLWELL BEHAVIORAL HEALTH SERVICES

MEDICARE: ALLWELL BEHAVIORAL HEALTH SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1233415000OTHEROHMAGELLAN FACILITY PIN

General Provider Information

NPI Number : 1528036431
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALLWELL BEHAVIORAL HEALTH SERVICES
Provider Business Mailing Address
First Line : 2845 BELL ST
Second Line :
City : ZANESVILLE
State : OH
Zip : 43701-1720
Country : US
Telephone Number : 740-454-9766
Fax Number : 740-588-6452
Provider Business Practice Location Address
First Line : 915 S RIVERSIDE DR NE
Second Line :
City : MCCONNELSVILLE
State : OH
Zip : 43756-9102
Country : US
Telephone Number : 740-962-5204
Fax Number : 740-962-3688
Authorized Official
Title or Position : PRESIDENT & CEO
Name : JAMES A MCDONALD
Credential : MA
Telephone Number : 740-454-9766
Provider Enumeration Date : 03/08/2006
Last Update Date : 04/26/2018

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Practice Location Address:
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1033456439 — MILLEE JEAN PARSONS LPCC
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1285972109 — MR. JUSTIN A KERR PMHNP-BC
Practice Location Address:
915 S RIVERSIDE DR NE
MCCONNELSVILLE, OH
43756-9102
Practice Phone: 740-454-9466
Practice Fax:
1063851798 — JILL R RILEY PCC
Practice Location Address:
915 S RIVERSIDE DR NE
MCCONNELSVILLE, OH
43756-9102
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Practice Fax: 740-588-6452
1538521562 — KIMBERLY L MOWRY LPN, QMHS
Practice Location Address:
915 S RIVERSIDE DR NE
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43756-9102
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1194273250 — ELAINE SHUSTER LCDCIII
Practice Location Address:
915 S RIVERSIDE DR NE
MCCONNELSVILLE, OH
43756-9102
Practice Phone: 740-962-6933
Practice Fax: 740-962-6305

Directions to “ALLWELL BEHAVIORAL HEALTH SERVICES ” Practice Location

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