NPIMap

Organization Active NPI

Mountain Laurel Group, LLC

  • Community/Behavioral Health Agency
  • Culpeper, VA
National Provider Identifier
1124343801
Registry record updated Apr 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
993-01019 Issued in VA
Legal business name
MOUNTAIN LAUREL GROUP, LLC
Practice address
14274 Eggbornsville Rd
Culpeper, VA 22701-4844
Phone
(540) 829-1789
Fax
(540) 829-0117
NPI assigned
Apr 6, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2010

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

Authorized official

Name
Bruce Wyman, LPC, EDMNPI 1821109331
Title
Ceo-Director of Programs- Owner
Phone
(540) 937-2334

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 993-01019 VA Primary

Addresses

Primary practice location

14274 Eggbornsville Rd
Culpeper, VA 22701-4844

Mailing address

10391 Greyson LN
Rixeyville, VA 22737-1730
Phone (540) 937-2334

National Provider Directory

National Provider Directory
Tax ID family
Mountain Laurel Group LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

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": "1270512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270512000000",
    "number": "1124343801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10391 GREYSON LN",
            "city": "RIXEYVILLE",
            "state": "VA",
            "postal_code": "227371730",
            "telephone_number": "540-937-2334",
            "fax_number": "540-937-7680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14274 EGGBORNSVILLE RD",
            "city": "CULPEPER",
            "state": "VA",
            "postal_code": "227014844",
            "telephone_number": "540-829-1789",
            "fax_number": "540-829-0117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN LAUREL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-06",
        "last_updated": "2010-04-06",
        "status": "A",
        "authorized_official_last_name": "WYMAN",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "CEO-DIRECTOR OF PROGRAMS- OWNER",
        "authorized_official_telephone_number": "540-937-2334",
        "authorized_official_credential": "LPC, EDM"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "VA",
            "license": "993-01019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Culpeper, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2010; 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.