MEDICARE: THE MENTAL HEALTH ASSOCIATION IN NORTH CAROLINA, INC.

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
1	251S00000X	Community/Behavioral Health Agency	MHL-013-118	NC

General Provider Information

NPI Number	:	1851412035
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE MENTAL HEALTH ASSOCIATION IN NORTH CAROLINA, INC.

Provider Business Mailing Address
First Line	:	1331 SUNDAY DR
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27607-5166
Country	:	US
Telephone Number	:	919-866-3287
Fax Number	:

Provider Business Practice Location Address
First Line	:	76 UNION ST S
Second Line	:
City	:	CONCORD
State	:	NC
Zip	:	28025-5014
Country	:	US
Telephone Number	:	919-866-3287
Fax Number	:

Authorized Official
Title or Position	:	FINANCIAL ASSISTANT
Name	:	MR. KEVIN COCHRAN
Credential	:
Telephone Number	:	919-866-3287

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	08/22/2020

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