Boomtown Mental Wellness Center

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

BOOMTOWN MENTAL WELLNESS CENTER

Practice address

4002 First Avenue
Nitro, WV 25143-2339

Phone

(304) 415-1551

NPI assigned

Jul 14, 2026

Organization subpart

No

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

Authorized official

Name

Mrs. Sarah Ellen Dean

Title

Owner

Phone

(304) 415-1551

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1783987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783987200000",
    "number": "1003735879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1458 SATTES CIR",
            "city": "NITRO",
            "state": "WV",
            "postal_code": "251432339",
            "telephone_number": "304-415-1551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4002 FIRST AVENUE",
            "city": "NITRO",
            "state": "WV",
            "postal_code": "251432339",
            "telephone_number": "304-415-1551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOOMTOWN MENTAL WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-14",
        "last_updated": "2026-07-14",
        "certification_date": "2026-06-22",
        "status": "A",
        "authorized_official_last_name": "DEAN",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-415-1551",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Bartram
• Heidi Bissell, FNP
• Mary Blankenship
• Jennifer Boggess
• Scott G Boggs, FNP-BC
• Clydena Jean Broughton, FNP - C
• Samuel Munsey Brown Jr.
• Gwen Leigh Bryant
• Faydra Dawn Carrington
• Marsha Casto

• All providers in Nitro, WV
• Mental Health Clinic/Center (Including Community Mental Health Center) in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.