MEDICARE: M & M BEHAVIORAL HEALTH SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251S00000X	Community/Behavioral Health Agency
2	261QM0855X	Adolescent and Children Mental Health Clinic/Center
3	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1851254098
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M & M BEHAVIORAL HEALTH SERVICES, LLC

Provider Business Mailing Address
First Line	:	1879 S SYCAMORE ST
Second Line	:
City	:	PETERSBURG
State	:	VA
Zip	:	23805-2730
Country	:	US
Telephone Number	:	804-926-9372
Fax Number	:

Provider Business Practice Location Address
First Line	:	1879 S SYCAMORE ST
Second Line	:
City	:	PETERSBURG
State	:	VA
Zip	:	23805-2730
Country	:	US
Telephone Number	:	804-926-9372
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	LAVONNE MOORE
Credential	:
Telephone Number	:	804-926-9372

Provider Enumeration Date	:	12/04/2025
Last Update Date	:	12/04/2025

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