Provider Demographics
NPI:1194329607
Name:PREMIER MENTAL HEALTH, LLC
Entity type:Organization
Organization Name:PREMIER MENTAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHENEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGEE FEARS
Authorized Official - Suffix:
Authorized Official - Credentials:CNP, PMHNP-BC
Authorized Official - Phone:216-273-4003
Mailing Address - Street 1:154 E AURORA RD # 204
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44067-2053
Mailing Address - Country:US
Mailing Address - Phone:216-273-4003
Mailing Address - Fax:
Practice Address - Street 1:3659 GREEN RD STE 322
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5715
Practice Address - Country:US
Practice Address - Phone:216-273-4003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-24
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0414784Medicaid