Provider Demographics
NPI:1366530305
Name:MENTAL HEALTH ASSOCIATES, INC.
Entity type:Organization
Organization Name:MENTAL HEALTH ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:A
Authorized Official - Last Name:KELL
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:215-396-2720
Mailing Address - Street 1:1880 AUGUST DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-1511
Mailing Address - Country:US
Mailing Address - Phone:215-396-2720
Mailing Address - Fax:215-396-8822
Practice Address - Street 1:1880 AUGUST DR
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-1511
Practice Address - Country:US
Practice Address - Phone:215-396-2720
Practice Address - Fax:215-396-8822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005817L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAME693170OtherPA BLUE SHIELD