NPIMap

Organization Active NPI

Community Growth Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Charleston, WV
National Provider Identifier
1043077290
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
COMMUNITY GROWTH BEHAVIORAL HEALTH
Practice address
602 Virginia St E Ste 100
Charleston, WV 25301-2154
Phone
(704) 361-1999
NPI assigned
Mar 4, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Authorized official

Name
Mrs. Artentus Lasha WilsonNPI 1770321606
Title
Owner
Phone
(704) 361-1999

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
Community/Behavioral Health Agency 251S00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

602 Virginia St E Ste 100
Charleston, WV 25301-2154

Mailing address

602 Virginia St E Ste 100
Charleston, WV 25301-2154
Phone (704) 361-1999

National Provider Directory

National Provider Directory

Locations

602 Virginia St E
Ste 100
Charleston, WV 25301
Phone (704) 361-1999

Practitioners & affiliated clinicians

Practitioners 2

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": "1709510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709510400000",
    "number": "1043077290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 VIRGINIA ST E STE 100",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253012154",
            "telephone_number": "704-361-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 VIRGINIA ST E STE 100",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253012154",
            "telephone_number": "704-361-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY GROWTH BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-04",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "ARTENTUS",
        "authorized_official_middle_name": "LASHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-361-1999",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; 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.