Mental Health Information System (MHIS) Manual
Page Posted: 06/02/14 | Page Reviewed: 8/22/2022 | Page Updated: 8/12/2019 |
4. Provider Information
Contact Information
The MHIS has a Provider Information page, which is maintained by each reporting agency.
The Provider Information page has two sections (1) the Provider Information tab and (2) the Provider Batch tab.
Category | Data Element | ||
Valid Entry | Field Length | ||
Required | Provider Information | ||
Provides IDDT Services | Yes or No | NA | |
Primary Contact Information | |||
Last Name | Alpha | 25 | |
First Name | Alpha | 25 | |
Telephone number | Numeric | 10 | |
Telephone extension | Numeric | 4 | |
Email address | Alphanumeric | 35 | |
Optional | Secondary Contact Information | ||
Last Name | Alpha | 25 | |
First Name | Alpha | 25 | |
Telephone number | Numeric | 10 | |
Telephone extension | Numeric | 4 | |
Email address | Alphanumeric | 35 | |
*Required | Team Information (* Housing with Supportive Services grantees, ACT, and Forensic ACT providers are required to Add a Team Code and Team Name. Optional for all other program/treatment providers.) | ||
Team Code | Text | 2 | |
Team Name | Alpha | 20 | |
*Required | Provider Batch (* when agency submits batch files for more than one NPI/UMPI) Secondary NPI information must match an agency MHCP enrolled mental health service location. Records reported under a non-enrolled mental health location will not be visible to search in MHIS. | ||
Secondary NPI/UMPI Number | Alphanumeric | 10 | |
Facility Location Zip code | Numeric | 9 | |
Facility Location Taxonomy | Numeric | 10 | |
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