Healthcare Provider Details

I. General information

NPI: 1407926686
Provider Name (Legal Business Name): MENTAL HEALTH ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 1ST ST SW
ROANOKE VA
24016-4701
US

IV. Provider business mailing address

1115 1ST ST SW
ROANOKE VA
24016-4701
US

V. Phone/Fax

Practice location:
  • Phone: 540-343-0004
  • Fax: 540-343-1576
Mailing address:
  • Phone: 540-343-0004
  • Fax: 540-343-1576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateVA

VIII. Authorized Official

Name: MRS. JINGER D SNAPP-LAPLACE
Title or Position: PRACTICE MANAGER
Credential:
Phone: 540-343-0004