Organization Active NPI

Solace Behavioral Healthcare Services

  • Psychiatric/Mental Health Nurse Practitioner
  • Fairmont, WV
National Provider Identifier
1003384751
Registry record updated Nov 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
SOLACE BEHAVIORAL HEALTHCARE SERVICES
Practice address
201 Adams St
Fairmont, WV 26554-2825
Phone
(304) 641-1809
NPI assigned
Nov 9, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Yolanda HunterNPI 1285022723
Title
NP/Director
Phone
(304) 641-1809

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

201 Adams St
Fairmont, WV 26554-2825

Mailing address

201 Adams St
Fairmont, WV 26554-2825

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190122000742 WV Part B Supplier - Clinic/Group Practice 1153668728 Receives reassigned benefits from 1 practitioner
Practice locations: Fairmont, WV

National Provider Directory

National Provider Directory

Locations

1228 Country Club Rd
Ste 800
Fairmont, WV 26554
Phone (304) 363-8844

201 Adams St
Fairmont, WV 26554
Phone (304) 534-8582

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1541721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573689600000",
    "number": "1003384751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 ADAMS ST",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265542825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 ADAMS ST",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265542825",
            "telephone_number": "304-641-1809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLACE BEHAVIORAL HEALTHCARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-09",
        "last_updated": "2019-11-14",
        "status": "A",
        "authorized_official_last_name": "HUNTER",
        "authorized_official_first_name": "YOLANDA",
        "authorized_official_title_or_position": "NP/DIRECTOR",
        "authorized_official_telephone_number": "304-641-1809"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairmont, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.