Provider Demographics
NPI:1407669062
Name:SYMPHONY MENTAL HEALTH LLC
Entity type:Organization
Organization Name:SYMPHONY MENTAL HEALTH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:ROD ALLEN
Authorized Official - Last Name:STILLION
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, PMHNP-BC
Authorized Official - Phone:785-289-3102
Mailing Address - Street 1:125 NAVARRE ST
Mailing Address - Street 2:
Mailing Address - City:ROSSVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:66533-9647
Mailing Address - Country:US
Mailing Address - Phone:785-289-3102
Mailing Address - Fax:
Practice Address - Street 1:125 NAVARRE ST
Practice Address - Street 2:
Practice Address - City:ROSSVILLE
Practice Address - State:KS
Practice Address - Zip Code:66533-9647
Practice Address - Country:US
Practice Address - Phone:785-289-3102
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health