Provider Demographics
NPI:1053586453
Name:MENTAL HEALTH RESOURCES
Entity type:Organization
Organization Name:MENTAL HEALTH RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR AND PSYCHOTHERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, APNP
Authorized Official - Phone:608-833-9770
Mailing Address - Street 1:402 GAMMON PL
Mailing Address - Street 2:SUITE 290
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-1045
Mailing Address - Country:US
Mailing Address - Phone:608-833-9779
Mailing Address - Fax:608-833-1197
Practice Address - Street 1:402 GAMMON PL
Practice Address - Street 2:SUITE 290
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-1045
Practice Address - Country:US
Practice Address - Phone:608-833-9779
Practice Address - Fax:608-833-1197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-25
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty