Healthcare Provider Details

I. General information

NPI: 1245303890
Provider Name (Legal Business Name): MONROE COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
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 0726
MONROE MI
48161-9754
US

V. Phone/Fax

Practice location:
  • Phone: 734-243-7340
  • Fax: 734-243-5506
Mailing address:
  • Phone: 734-243-7340
  • Fax: 734-243-5506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LISA GRAHAM
Title or Position: CEO
Credential: LMSW
Phone: 734-243-7340