Provider Demographics
NPI:1962551275
Name:MENTAL HEALTH ASSOCIATES,LLC
Entity type:Organization
Organization Name:MENTAL HEALTH ASSOCIATES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:ACKER
Authorized Official - Last Name:MARANDOLA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:712-255-8323
Mailing Address - Street 1:2212 PIERCE ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51104-3871
Mailing Address - Country:US
Mailing Address - Phone:712-255-8323
Mailing Address - Fax:712-255-8287
Practice Address - Street 1:2212 PIERCE ST
Practice Address - Street 2:SUITE 100
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51104-3871
Practice Address - Country:US
Practice Address - Phone:712-255-8323
Practice Address - Fax:712-255-8287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty