PETERSBURG MENTAL HEALTH SERVICES, INC. - NPI 1174690309

Q: What is Petersburg Mental Health Services, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

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About Petersburg Mental Health Services, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PETERSBURG MENTAL HEALTH SERVICES, INC. (NPI 1174690309) is a healthcare organization registered as a mental health (including community mental health center) in Petersburg, Alaska and active in the NPI registry since November 2006. The organization lists Susan Ohmer, Director, as its authorized official.

NPPES Registry Identity

NPI1174690309

Entity TypeOrganization

Primary Taxonomy261QM0801X

Legal Business NamePETERSBURG MENTAL HEALTH SERVICES, INC.

Location Address201 NORTH NORDIC DRIVEPetersburg, AK 99833-1309

Mailing AddressPo Box 1309Petersburg, AK 99833-1309 · (907) 772-3332 · Fax (888) 858-8850

Phone(907) 772-3332

Fax(888) 858-8850

Organization SubpartNo

Authorized OfficialSusan OhmerDirector · (907) 772-3332

Enumeration DateNovember 30, 2006

Last NPPES UpdateJuly 22, 2010

✔ NPI 1174690309 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities

Taxonomy Code261QM0801X

License✔ Licensed in AK · 282463

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 282463 (AK)

Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X · License 282463 (AK)

201 NORTH NORDIC DRIVE, Petersburg, AK 99833

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Other Identifiers 5

Medicare ID-Type Unspecified152998AK · Individual Clinician #

MedicaidMH1413AK

MedicaidDA1413AK

Medicare ID-Type Unspecified152994AK · Group Number

Medicare ID-Type Unspecified152996AK · Individual Clinician #

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..Insurance ›

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHADWICK WRIGHT MS

Counselor (Mental Health)