MOUNTAINEER PSYCHOLOGICAL SERVICES (NPI# 1306242540) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306242540 |
| Entity Type | Organization |
| Organization Name | MOUNTAINEER PSYCHOLOGICAL SERVICES |
| Other Organization Name | MOUNTAINEER PSYCHOLOGICAL SERVICES PLLC |
| Practice Address |
4000 Coombs Farm Drive Bldg D Unit 102 Morgantown WV 26508 |
| Practice Telephone | 3042411766 |
| Practice Fax Number | 3043812648 |
| Mailing Telephone | 3042411766 |
| Mailing Fax Number | 3043812648 |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2016-05-25 |
| Authorized Official Name | DR. JENNIFER GURIEL MYERS (PSYCHOLOGIST/OWNER) |
| Authorized Official Telephone | 3042411766 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | 926 | WV | Agencies |
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
926 | WV | Behavioral Health & Social Service Providers |
| N | 103TF0200X |
Psychologist Specialization: Forensic |
926 | WV | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
926 | WV | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 3910006572 | 05 |
| Other Name | Type Code |
|---|---|
| Mountaineer Psychological Services PLLC | Doing Business As Name - Organization |
| Street Address |
4000 COOMBS FARM DRIVE BLDG D UNIT 102 |
| City | MORGANTOWN |
| State | WV |
| Zip Code | 26508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750989026 | Ruth Gibson | Technician | 4 Elpaso Ave, Morgantown, WV 26508 | 2020-10-09 |
| 1518565845 | Anne Jiang | Pharmacist | 7000 Mid Atlantic Dr., Morgantown, WV 26508 | 2020-10-09 |
| 1396356283 | Jessica Dawn Taylor | Technician | Lot 128 Healthy Heights Village, Morgantown, WV 26508 | 2020-08-13 |
| 1992297733 | Jeffrey G Minchau Dds Ms | Dentist | 9000 Coombs Farm Dr, Ste 304, Morgantown, WV 26508 | 2018-06-06 |
| 1346796257 | Gregory Ice | Social Worker | 1627 Grafton Rd, Morgantown, WV 26508 | 2016-08-31 |
| 1750722906 | Tingler Rx | Pharmacy | 889 Venture Drive, Suite 2, Morgantown, WV 26508 | 2013-07-16 |
| 1881033983 | Amy Rodgers Smith | Music Therapist | 714 Venture Drive #115, Morgantown, WV 26508 | 2013-06-21 |
| 1013250588 | Walid Radwan | Student in an Organized Health Care Education/Training Program | 1121 Eagle Run Road, Morgantown, WV 26508 | 2013-04-02 |
| 1467727040 | Sara Lyndsey Disimone | Counselor | 3000 Coombs Farm Road, Suite 102, Morgantown, WV 26508 | 2012-03-15 |
| 1194013227 | Marc Anthony Phillips | Pharmacist | 1021 Laurelwood Drive, Morgantown, WV 26508 | 2011-07-11 |
| Find all providers in zip 26508 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235508896 | Robert Leonard Roff | Psychologist | 1404 Bradford Ln, Morgantown, WV 26508-4855 | 2015-09-24 |
| 1710255666 | Daniel Gregory Long II | Psychologist | 1553 Stewartstown Road, Morgantown, WV 26505-2947 | 2011-12-07 |
| 1376780221 | Jennifer Myers | Psychologist | 4000 Coombs Farm Rd, Bldg D Unit 012, Morgantown, WV 26508-1124 | 2009-01-14 |
| 1063574713 | Janis Boury | Psychologist | 644 White Ave, Morgantown, WV 26507 | 2006-12-15 |
| 1881773612 | Michael Arthur Todt | Psychologist | 870 Bloody Run Rd, Morgantown, WV 26508-4794 | 2006-11-03 |
| 1316957087 | Diane Woodrum-leuthold | Psychologist | 1224 Pineview Dr # B, Morgantown, WV 26505-2714 | 2006-08-08 |
| 1538178116 | Kathryn Wright | Psychologist | 1286 Suncrest Town Centre Dr, Morgantown, WV 26505-1828 | 2006-08-05 |
| 1205859006 | George David Allen | Psychologist | 1062 Maple Dr Ste 1, Morgantown, WV 26505-0809 | 2006-07-25 |
| 1326076308 | William J Fremouw | Psychologist | 1224 Pineview Dr Ste B, Morgantown, WV 26505-0708 | 2006-06-29 |
| 1366482671 | Patricia Denunzio Kreider | Psychologist | 3024 North St, Morgantown, PA 19543-7726 | 2006-06-07 |
| Find all providers in MORGANTOWN | ||||
| City | MORGANTOWN |
| Zip Code | 26508 |
Please comment or provide details below to improve the information on MOUNTAINEER PSYCHOLOGICAL SERVICES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.