Organization Active NPI

MB Integrative Mental Health, PC

  • Psychiatric/Mental Health Nurse Practitioner
  • Canonsburg, PA
National Provider Identifier
1093385494
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MB INTEGRATIVE MENTAL HEALTH, PC
Practice address
2400 Ansys Dr
Canonsburg, PA 15317-0403
Phone
(724) 601-4790
NPI assigned
Jun 28, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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

Authorized official

Name
Dr. Mary Beth Rucki, DNP, PMHNP-BC
Title
Nurse Practitioner
Phone
(724) 601-4790

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

2400 Ansys Dr
Canonsburg, PA 15317-0403

Mailing address

2400 Ansys Dr
Canonsburg, PA 15317-0403
Phone (724) 601-4790

Other names 1

  • None Other name

National Provider Directory

National Provider Directory

Locations

2400 Ansys Dr
Canonsburg, PA 15317
Phone (412) 523-8757

NPI Registry JSON

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624838400000",
    "number": "1093385494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 ANSYS DR",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153170403",
            "telephone_number": "724-601-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 ANSYS DR",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153170403",
            "telephone_number": "724-601-4790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MB INTEGRATIVE MENTAL HEALTH, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-28",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A",
        "authorized_official_last_name": "RUCKI",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "BETH",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "724-601-4790",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "None",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Canonsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; 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.