NPIMap

Organization Active NPI

Chameleon Health Care Inc

  • Clinical Psychologist
  • Summersville, WV
National Provider Identifier
1134200769
Registry record updated Dec 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
683 Issued in WV
Legal business name
CHAMELEON HEALTH CARE INC
Practice address
846 Northside Drive
Suite 15
Summersville, WV 26651-2028
Phone
(304) 872-8995
Fax
(304) 872-8997
NPI assigned
Oct 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2013

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

Authorized official

Name
Mr. Michael Morrello, MSNPI 1659542041
Title
President
Phone
(304) 872-8995

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
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 683 WV Primary

Addresses

Primary practice location

846 Northside Drive
Suite 15
Summersville, WV 26651-2028

Mailing address

846 Northside Drive
Suite 15
Summersville, WV 26651-2028
Phone (304) 872-8995

Other identifiers 2

IdentifierTypeStateIssuer
0164780000MedicaidWV
001715098OtherWVMOUNTAIN STATE BCBS

National Provider Directory

National Provider Directory

Locations

846 Northside Dr
Ste 15
Summersville, WV 26651
Phone (304) 872-8995

Practitioners & affiliated clinicians

Practitioners 1

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": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387152000000",
    "number": "1134200769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "846 NORTHSIDE DRIVE",
            "address_2": "SUITE 15",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266512028",
            "telephone_number": "304-872-8995",
            "fax_number": "304-872-8997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "846 NORTHSIDE DRIVE",
            "address_2": "SUITE 15",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266512028",
            "telephone_number": "304-872-8995",
            "fax_number": "304-872-8997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMELEON HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2013-12-16",
        "status": "A",
        "authorized_official_last_name": "MORRELLO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-872-8995",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "WV",
            "license": "683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0164780000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOUNTAIN STATE BCBS",
            "identifier": "001715098",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summersville, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2013; 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.