# NEW MERCY BEHAVIORAL HEALTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114480753
- **Authorized official:** LYNETTE CLARK (CREDENTIALING MANAGER)
- **Authorized official phone:** (770) 339-7667

## Contact information

- **Practice address:** 135 BOUNDS ST, JACKSON, MS 39206-4121
- **Practice address phone:** (601) 808-1820
- **Mailing address:** PO BOX 1491, AUGUSTA, GA 30903-1491
- **Mailing address phone:** (601) 808-1820

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 04/10/2019
- **Last updated:** 05/06/2021