Individual provider Active NPI

Ann Marie Sumpter, NCC

  • Counselor
  • Beaver, WV
National Provider Identifier
1124781638
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
1374776 Issued in WV
Practice address
4234 Grandview Rd
Beaver, WV 25813-9105
Phone
(706) 573-7725
NPI assigned
Oct 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 1374776 WV Primary

Addresses

Primary practice location

4234 Grandview Rd
Beaver, WV 25813-9105

Mailing address

4234 Grandview Rd
Beaver, WV 25813-9105
Phone (706) 573-7725

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240312004122 WV Practitioner - Mental Health Counselor 9234575291 Reassigns benefits to 2 organizations
I20260611000928 WA Practitioner - Mental Health Counselor 9234575291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

612 Bigelow St
Twisp, WA 98856-5836

PO Box
Suite 12017
Olympia, WA 98508-2017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1374776WVMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Nuskool Scholars CurrentSince Oct 24, 2021 Accepting new patients
Winds of Change Recovery and Mental Health LLC CurrentSince Jan 1, 2024 Accepting new patients
Nuskool Scholars CurrentSince Oct 24, 2021 Accepting new patients
Talkspace Provider Network PA CurrentSince Jan 23, 2025 Accepting new patients

Locations

2578 Broadway
Ste 607
New York, NY 10025
Phone (304) 308-3735

311 Prince St
Beckley, WV 25801
Phone (304) 953-3987

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1634774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1124781638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4234 GRANDVIEW RD",
            "city": "BEAVER",
            "state": "WV",
            "postal_code": "258139105",
            "telephone_number": "706-573-7725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4234 GRANDVIEW RD",
            "city": "BEAVER",
            "state": "WV",
            "postal_code": "258139105",
            "telephone_number": "706-573-7725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMPTER",
        "first_name": "ANN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-21",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WV",
            "license": "1374776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaver, WV

Sources for this page

Verify at the official NPI Registry.