Provider Demographics
NPI:1548055932
Name:ELOHIM MENTAL HEALTH ASSOCIATES
Entity type:Organization
Organization Name:ELOHIM MENTAL HEALTH ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:THANDIWE
Authorized Official - Middle Name:
Authorized Official - Last Name:BALLARD
Authorized Official - Suffix:
Authorized Official - Credentials:CNP
Authorized Official - Phone:937-813-0060
Mailing Address - Street 1:2555 S DIXIE DR STE 260A
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45409-1542
Mailing Address - Country:US
Mailing Address - Phone:937-350-1640
Mailing Address - Fax:
Practice Address - Street 1:2555 S DIXIE DR STE 260A
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-1542
Practice Address - Country:US
Practice Address - Phone:937-350-1640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-14
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty