Provider Demographics
NPI:1487891198
Name:MENTAL HEALTH SOLUTIONS, P.C.
Entity type:Organization
Organization Name:MENTAL HEALTH SOLUTIONS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIGHT-PROPHET
Authorized Official - Middle Name:ETERNITY
Authorized Official - Last Name:FELLOWES
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, LP
Authorized Official - Phone:847-566-0164
Mailing Address - Street 1:101 LIONS DR
Mailing Address - Street 2:SUITE 115
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-3181
Mailing Address - Country:US
Mailing Address - Phone:847-566-0164
Mailing Address - Fax:847-277-7235
Practice Address - Street 1:101 LIONS DR
Practice Address - Street 2:SUITE 115
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-3181
Practice Address - Country:US
Practice Address - Phone:847-566-0164
Practice Address - Fax:847-277-7235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-16
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071007152103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty