Provider Demographics
NPI:1124157854
Name:MENTAL HEALTH ASSOCIATION OF ORANGE COUNTY
Entity type:Organization
Organization Name:MENTAL HEALTH ASSOCIATION OF ORANGE COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:A
Authorized Official - Last Name:THRASH
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:714-547-7559
Mailing Address - Street 1:822 W TOWN AND COUNTRY RD
Mailing Address - Street 2:WIT COURT & CHOICES FSP
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4712
Mailing Address - Country:US
Mailing Address - Phone:714-547-7559
Mailing Address - Fax:714-543-4431
Practice Address - Street 1:2416 S MAIN ST
Practice Address - Street 2:SUITE A & B, WIT COURT & CHOICES FSP
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92707-3255
Practice Address - Country:US
Practice Address - Phone:714-668-8498
Practice Address - Fax:714-668-8499
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MENTAL HEALTH ASSOCIATION OF ORANGE COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-06
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW13874Medicare UPIN