Mountain Mental Health

Key facts

NPI

1124716261

Entity type

Organization (NPI type 2)

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Legal business name

MOUNTAIN MENTAL HEALTH

Practice address

78 N Main St Unit 208
Driggs, ID 83422-5141

Phone

(307) 699-0489

NPI assigned

Apr 26, 2023

Organization subpart

No

Authorized official

Name

Charlotte P. Diprisco, MS NPI 1457701229

Title

Therapist

Phone

(307) 699-0489

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charlotte Diprisco, M.S., P.P.C. Counselor · Jackson, WY · NPI 1457701229
  NPD Authorized official

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 26, 2023.

{
    "created_epoch": "1682467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682467200000",
    "number": "1124716261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 ABBY LOOP UNIT 15",
            "city": "VICTOR",
            "state": "ID",
            "postal_code": "834551309",
            "telephone_number": "307-699-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 N MAIN ST UNIT 208",
            "city": "DRIGGS",
            "state": "ID",
            "postal_code": "834225141",
            "telephone_number": "307-699-0489"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 E Broadway Ave",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "WY",
            "postal_code": "830018636",
            "country_code": "US",
            "telephone_number": "307-699-0489",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MOUNTAIN MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-26",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A",
        "authorized_official_last_name": "DIPRISCO",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "307-699-0489",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Driggs, ID · Mental Health Clinic/Center (Including Community Mental Health Center) in Idaho