Provider Demographics
NPI:1154875656
Name:LAWRENCE COUNTY MENTAL HEALTH & WELLNESS
Entity type:Organization
Organization Name:LAWRENCE COUNTY MENTAL HEALTH & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCMULLEN
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:724-856-3167
Mailing Address - Street 1:3411 WILMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-3209
Mailing Address - Country:US
Mailing Address - Phone:724-856-3167
Mailing Address - Fax:724-856-8188
Practice Address - Street 1:3411 WILMINGTON RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-3209
Practice Address - Country:US
Practice Address - Phone:724-856-3167
Practice Address - Fax:724-856-8188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-12
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty