Healthcare Provider Details

I. General information

NPI: 1770403925
Provider Name (Legal Business Name): MARIANAS MENTAL HEALTH INITIATIVE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4081 J LEE BUILDING
SAIPAN MP
96950
US

IV. Provider business mailing address

PO BOX 500756
SAIPAN MP
96950-0756
US

V. Phone/Fax

Practice location:
  • Phone: 670-286-2420
  • Fax:
Mailing address:
  • Phone: 670-286-2420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MONICA DAWN LEE
Title or Position: VICE PRESIDENT
Credential: DNP, PMHNP-BC, FNP-B
Phone: 501-206-8789