Mustard Seed Counseling and Behavioral Health Services LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

MUSTARD SEED COUNSELING AND BEHAVIORAL HEALTH SERVICES LLC

Practice address

428 Leon Sullivan Way
Charleston, WV 25301-1713

Phone

(304) 400-4068

Fax

(304) 400-4069

NPI assigned

Jan 26, 2023

Last updated

May 9, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Angela Jean Phares, PMHNPNPI 1023530110

Title

Owner

Phone

(304) 400-4068

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

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.

• Angela Phares

  • Family Nurse Practitioner
  • South Point, OH
  • NPI 1023530110

  WV

  Medicare reassignment NPD Authorized official
• Tiffany R Hersman, MA, BSW, AAS

  • Social Worker
  • Charleston, WV
  • NPI 1386346112
  NPD
• Jeri Sue Thomas, CNP

  • Nurse Practitioner
  • Green Bank, WV
  • NPI 1881920387
  NPD
• Megan Renee Mitchell

  • Mental Health Counselor
  • Elkview, WV
  • NPI 1548079809
  NPD (past)

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

{
    "created_epoch": "1674691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715212800000",
    "number": "1114633773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 694",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255260694",
            "telephone_number": "304-409-8128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 LEON SULLIVAN WAY",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011713",
            "telephone_number": "304-400-4068",
            "fax_number": "304-400-4069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUSTARD SEED COUNSELING AND BEHAVIORAL HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-26",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-08",
        "status": "A",
        "authorized_official_last_name": "PHARES",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-400-4068",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bakhtawar Mushtaq, MD
• Angel Dawn Music
• Kristopher Musick, PA
• Pamela A Musick, RN
• Muhammad Mussa, M.D.
• Amber Lynn Mutimer, APRN, NP-C
• Deidra Fawn Muto, M.D.
• Frank A. Muto, M.D.
• My September LLC (My September Case Management)
• My Vein Care, Inc.

• Psychiatric/Mental Health Nurse Practitioner in Charleston, WV
• Providers in Charleston, WV by specialty
• Psychiatric/Mental Health Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; 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.