Provider Demographics
NPI:1316722333
Name:S.I.S MENTAL HEALTH SERVICES
Entity type:Organization
Organization Name:S.I.S MENTAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRNP
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:334-421-0692
Mailing Address - Street 1:445 DEXTER AVE STE 4050
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36104-3867
Mailing Address - Country:US
Mailing Address - Phone:334-421-0692
Mailing Address - Fax:
Practice Address - Street 1:445 DEXTER AVE STE 4050
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36104-3867
Practice Address - Country:US
Practice Address - Phone:334-421-0692
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty