| Mission Behavioral Health, Llc | |
|
22270 Us Highway 72 Ste B Athens AL 35613-2604 | |
| (256) 795-8143 | |
| (256) 427-4165 |
| Full Name | Mission Behavioral Health, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 22270 Us Highway 72 Ste B, Athens, Alabama |
| Authorized Official Name and Position | Richard Wade Menefee (MANAGING PARTNER) |
| Authorized Official Contact | 2562780569 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mission Behavioral Health, Llc 3479 County Road 94 Florence AL 35634-4845 Ph: (256) 698-0135 | Mission Behavioral Health, Llc 22270 Us Highway 72 Ste B Athens AL 35613-2604 Ph: (256) 795-8143 |
| NPI Number | 1235724238 |
|---|---|
| Provider Enumeration Date | 03/02/2021 |
| Last Update Date | 05/28/2026 |
| Certification Date | 05/28/2026 |
| Medicare PECOS PAC ID | 8628485935 |
|---|---|
| Medicare Enrollment ID | O20210405001325 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235724238 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Leah G Lucas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922254762 PECOS PAC ID: 9234394842 Enrollment ID: I20120705000479 |
| Provider Name | Kerri L Wiley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447565668 PECOS PAC ID: 3577757970 Enrollment ID: I20160216000882 |
| Provider Name | Chastity D Ayers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043704455 PECOS PAC ID: 9739423435 Enrollment ID: I20181206003060 |
| Provider Name | Kimberly S. Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457844573 PECOS PAC ID: 7113267329 Enrollment ID: I20190326002907 |
| Provider Name | Richard Wade Menefee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922848688 PECOS PAC ID: 3072044924 Enrollment ID: I20241002001305 |
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