Provider Demographics
NPI:1487316576
Name:ADVOCATE MENTAL HEALTH SERVICES LLC
Entity type:Organization
Organization Name:ADVOCATE MENTAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MCGLONE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:479-518-8549
Mailing Address - Street 1:PO BOX 233
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72845-0233
Mailing Address - Country:US
Mailing Address - Phone:479-518-8549
Mailing Address - Fax:
Practice Address - Street 1:1124 S ROGERS ST STE 3
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:AR
Practice Address - Zip Code:72830-7046
Practice Address - Country:US
Practice Address - Phone:479-309-9029
Practice Address - Fax:479-398-8346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-06
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty