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Contact Information

ALLIED MENTAL HEALTH SPECIALTY GROUP SC
1334 HOSFORD ST STE B
HUDSON, WI54016-9230
 Phone: 715-808-0795
 Fax: 715-808-0361
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
 

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for ALLIED MENTAL HEALTH SPECIALTY GROUP SC

NPI # 1831315191
LBN Legal business name ALLIED MENTAL HEALTH SPECIALTY GROUP SC
Authorized official BRADLEY NEVINS - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 04/17/2007
Last updated 05/09/2020 - About 6 years ago
Identifiers
WI License # 1436-057
MN Medicaid 165875100
WI Medicaid 39087700
WI Medicaid 39692000
MN Other 87G89NE BCBS AUDREY NEVINS
MN Other 96G67SI BCBS IND NUM A SILER
MN Other 277P4NE BCBS IND PROV NUM BNEVINS
MN Other 110795 BNEVINS HEALTHPARTNERS GR
MN Other 87G99BR GROUP NUM A NEVINS
MN Other 96G77BR GROUP NUM ASILER
MN Other 276P4BR GROUP NUMBER BCBS BNEVINS
MN Other 1982771317 NPI IND NUM ANGELA SILER
MN Other 936451035211 PREFERREDONE ANEVINS PIN
WI Other 374826056003 BCBS ANEVINS PIN
WI Other 39172147012 BCBS GROUP NUMBER BEVINS
WI Other 471547731E03 BCBS PIN BNEVINS
WI Other 1710043070 NPI INDIVIDUAL ANEVINS
WI Other 62-70147 UBH AUDREYNEVINS
WI Other 61-57474 UBH BRAD NEVINS
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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