NPIMap

Organization Active NPI

Triple Willow Mental Health Clinic, Inc

  • Professional Counselor
  • Mechanicsville, VA
National Provider Identifier
1023490711
Registry record updated Nov 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701006887 Issued in VA
Legal business name
TRIPLE WILLOW MENTAL HEALTH CLINIC, INC
Practice address
7300 Hanover Green Dr Ste 100
Mechanicsville, VA 23111-1705
Phone
(804) 781-4418
Fax
(804) 212-0981
NPI assigned
Jun 18, 2015
Last updated
Nov 3, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2017

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

Authorized official

Name
Kyle Don McCall, MED, LPC, DCCNPI 1801272612
Title
President
Phone
(804) 781-4418

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Adult Mental Health Clinic/Center 261QM0850X NU
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU
Professional Counselor 101YP2500X 0701006887 VA Primary

Addresses

Primary practice location

7300 Hanover Green Dr Ste 100
Mechanicsville, VA 23111-1705

Mailing address

7300 Hanover Green Dr Ste 100
Mechanicsville, VA 23111-1705
Phone (804) 781-4418

Other names 1

  • Triple Willow Mental Health, Inc Former legal business name

National Provider Directory

National Provider Directory

Locations

7300 Hanover Green Dr
Ste 100
Mechanicsville, VA 23111
Phone (804) 781-4418

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1434585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509667200000",
    "number": "1023490711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 HANOVER GREEN DR STE 100",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231111705",
            "telephone_number": "804-781-4418",
            "fax_number": "804-212-0981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 HANOVER GREEN DR STE 100",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231111705",
            "telephone_number": "804-781-4418",
            "fax_number": "804-212-0981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIPLE WILLOW MENTAL HEALTH CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-18",
        "last_updated": "2017-11-03",
        "status": "A",
        "authorized_official_last_name": "MCCALL",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "DON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "804-781-4418",
        "authorized_official_credential": "MED, LPC, DCC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701006887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Triple Willow Mental Health, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Mechanicsville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2017; 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.