MEDICARE: MENTAL HEALTH PRIORITY MHP

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency
2	1041C0700X	Clinical Social Worker

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922777549
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MENTAL HEALTH PRIORITY MHP

Provider Business Mailing Address
First Line	:	4235 PINE SHADOWS LN
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70615-2992
Country	:	US
Telephone Number	:	337-391-1860
Fax Number	:

Provider Business Practice Location Address
First Line	:	7740 COHENOUR RD
Second Line	:
City	:	ORANGE
State	:	TX
Zip	:	77632-5969
Country	:	US
Telephone Number	:	337-704-6930
Fax Number	:	225-282-1010

Authorized Official
Title or Position	:	CEO
Name	:	KIMBERLY N MOTON
Credential	:	LCSW
Telephone Number	:	337-391-1860

Provider Enumeration Date	:	09/08/2021
Last Update Date	:	08/17/2023

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