Healthcare Provider Details

I. General information

NPI: 1366756157
Provider Name (Legal Business Name): MONROE COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2010
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 S RAISINVILLE RD
MONROE MI
48161-9754
US

IV. Provider business mailing address

1001 S RAISINVILLE RD PO BOX 726
MONROE MI
48161-9754
US

V. Phone/Fax

Practice location:
  • Phone: 734-243-7340
  • Fax: 734-243-0145
Mailing address:
  • Phone: 734-243-7340
  • Fax: 734-243-0145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: LISA GRAHAM
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: LMSW
Phone: 734-243-7340