DUNCANVILLE MENTAL HEALTH SERVICES (NPI# 1710474077) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710474077 |
| Entity Type | Organization |
| Organization Name | DUNCANVILLE MENTAL HEALTH SERVICES |
| Practice Address |
4333 Gannon Ln Ste 101 Dallas TX 75237-4222 |
| Mailing Address |
150 E Highway 67 Ste 204 Duncanville TX 75137-4481 |
| Practice Telephone | 9722839090 |
| Practice Fax Number | 9724990637 |
| Mailing Telephone | 4698798328 |
| Mailing Fax Number | 4699164677 |
| Enumeration Date | 2018-04-21 |
| Last Update Date | 2018-08-17 |
| Authorized Official Name | KENNETH R MEDLOCK (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 4698798328 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| N | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities | ||
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Street Address |
4333 GANNON LN STE 101 |
| City | DALLAS |
| State | TX |
| Zip Code | 75237-4222 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912485228 | Sonya Frank | Social Worker | 4333 Gannon Ln Ste 101, Dallas, TX 75237-4222 | 2018-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184223372 | Advanced Medical Services Associates, LLC | Clinic/Center | Advanced Urgent Care Center, 3690 W Wheatland Rd, Suite 150, Dallas, TX 75237 | 2020-10-20 |
| 1225520455 | Ethan William Gingras | Nurse Practitioner | 39769 I-20, Dallas, TX 75237 | 2018-06-04 |
| 1376031450 | Maria North | Student in an Organized Health Care Education/Training Program | Methodist Charlton Medical Center, 3500 W. Wheatland Road, Dallas, TX 75237 | 2018-04-25 |
| 1639671118 | Arquimedes Hernandez Perez | Registered Nurse | 6010 S Westmoreland Rd 423, Dallas, TX 75237 | 2018-03-01 |
| 1275055832 | Tanaka Transport | Non-emergency Medical Transport (VAN) | 4353 Gannon Ln Ste 103-a, Dallas, TX 75237 | 2017-07-14 |
| 1730620543 | Joshua Vong | Physical Therapist | 3107 W. Camp Wisdom Road Suite 131, Dallas, TX 75237 | 2017-03-13 |
| 1821537507 | Votka Sbong | Chiropractor | 2525 W. Wheatland Rd. Ste 230, Dallas, TX 75237 | 2017-02-15 |
| 1508304957 | Archana Srivastava Md Pa | Internal Medicine | 4305 W. Wheatland Road, Suite 130, Dallas, TX 75237 | 2017-02-06 |
| 1295272045 | Stafford Family Enterprises LLC | Dentist | 3306 West Camp Wisdom, Suite 100, Dallas, TX 75237 | 2017-01-31 |
| 1891170585 | Philip James Tyler | Chiropractor | 7125 Marvin D Love Fwy Ste 107, Dallas, TX 75237 | 2015-07-23 |
| Find all providers in zip 75237 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821603390 | Allison A Roberts | Community/Behavioral Health | 8403 Midway Rd, Dallas, TX 75209-2835 | 2020-09-11 |
| 1033736582 | Jomarv Inc | Community/Behavioral Health | 326 E 12th St, Dallas, TX 75203-2606 | 2020-07-01 |
| 1578189940 | Your Discovery Place Inc | Community/Behavioral Health | 3155 S Lancaster Rd Ste 200, Dallas, TX 75216-4586 | 2020-06-22 |
| 1205459062 | Trinity Counseling and Wellness Services | Community/Behavioral Health | 1910 Pacific Ave Ste 14160, Dallas, TX 75201-4753 | 2020-05-27 |
| 1437799350 | Ayuda Health Partners, LLC | Community/Behavioral Health | 2600 Cole Ave Apt 408, Dallas, TX 75204-4023 | 2020-01-08 |
| 1780242214 | Precision Behavioral Health Services, LLC | Community/Behavioral Health | 14100 Montfort Dr, Ste 1236, Dallas, TX 75254-3021 | 2019-05-30 |
| 1508328287 | New Hope Counseling Agency | Community/Behavioral Health | 4311 Belmont Ave Ste 105, Dallas, TX 75204-3032 | 2019-04-02 |
| 1669938544 | Patricia Ann Smith | Community/Behavioral Health | 385 Victoria Heights Dr, Dallas, GA 30132-9276 | 2019-02-14 |
| 1639657976 | Job Sterling | Community/Behavioral Health | 1409 N Zang Blvd Apt 218, Dallas, TX 75203-1203 | 2018-07-30 |
| 1063900090 | Paul Kehinde Aremu | Community/Behavioral Health | 9830 Paramount Ave, Dallas, TX 75217-3762 | 2018-04-25 |
| Find all providers in DALLAS | ||||
Please comment or provide details below to improve the information on DUNCANVILLE MENTAL HEALTH SERVICES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.