Provider Demographics
NPI:1316641715
Name:MAGNOLIA MENTAL HEALTH SOLUTIONS
Entity type:Organization
Organization Name:MAGNOLIA MENTAL HEALTH SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:225-337-1428
Mailing Address - Street 1:439 CECIL RD
Mailing Address - Street 2:
Mailing Address - City:TROUT
Mailing Address - State:LA
Mailing Address - Zip Code:71371-4105
Mailing Address - Country:US
Mailing Address - Phone:225-337-1428
Mailing Address - Fax:
Practice Address - Street 1:439 CECIL RD
Practice Address - Street 2:
Practice Address - City:TROUT
Practice Address - State:LA
Practice Address - Zip Code:71371-4105
Practice Address - Country:US
Practice Address - Phone:225-337-1428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty