| Mack Mental Health Group Llc | |
|
1925 W Andrew Johnson Hwy Unit 1 Morristown TN 37814-3757 | |
| (423) 258-2161 | |
| Not Available |
| Full Name | Mack Mental Health Group Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1925 W Andrew Johnson Hwy Unit 1, Morristown, Tennessee |
| Authorized Official Name and Position | George Mack (OWNER/CLINICIAN) |
| Authorized Official Contact | 4232582161 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mack Mental Health Group Llc 1925 W Andrew Johnson Hwy Unit 1 Morristown TN 37814-3757 Ph: (423) 258-2161 | Mack Mental Health Group Llc 1925 W Andrew Johnson Hwy Unit 1 Morristown TN 37814-3757 Ph: (423) 258-2161 |
| NPI Number | 1922691930 |
|---|---|
| Provider Enumeration Date | 02/19/2021 |
| Last Update Date | 06/08/2021 |
| Certification Date | 03/17/2021 |
| Medicare PECOS PAC ID | 5698112431 |
|---|---|
| Medicare Enrollment ID | O20240328001296 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922691930 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | George Mack |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699389601 PECOS PAC ID: 6507203346 Enrollment ID: I20240328001611 |
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