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Organization

ALLIED MENTAL HEALTH SPECIALTY GROUP SC

Active
Other names
Allied Mental Health Specialty Group SC
Organization subpart
No

Provider details

NPI number
Authorized official
BRADLEY G NEVINS (OWNER)
(715) 808-0795
Entity
Organization

Contact information

Practice address
1334 HOSFORD ST STE B, HUDSON, WI 54016-9230
(715) 808-0795
(715) 808-0361
Mailing address
1334 HOSFORD ST STE B, HUDSON, WI 54016-9230
(715) 808-0795
(715) 808-0361

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
103TC0700X
Clinical Psychologist
1436-057
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110795
BNEVINS HEALTHPARTNERS GR
MN
05
165875100
MN
01
1710043070
NPI INDIVIDUAL ANEVINS
WI
01
1982771317
NPI IND NUM ANGELA SILER
MN
01
276P4BR
GROUP NUMBER BCBS BNEVINS
MN
01
277P4NE
BCBS IND PROV NUM BNEVINS
MN
01
374826056003
BCBS ANEVINS PIN
WI
05
39087700
WI
01
39172147012
BCBS GROUP NUMBER BEVINS
WI
05
39692000
WI
01
471547731E03
BCBS PIN BNEVINS
WI
01
61-57474
UBH BRAD NEVINS
WI
01
62-70147
UBH AUDREYNEVINS
WI
01
87G89NE
BCBS AUDREY NEVINS
MN
01
87G99BR
GROUP NUM A NEVINS
MN
01
936451035211
PREFERREDONE ANEVINS PIN
MN
01
96G67SI
BCBS IND NUM A SILER
MN
01
96G77BR
GROUP NUM ASILER
MN
Enumeration date
04/17/2007
Last updated
05/09/2020
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