MBH Physician Group -WV PLLC

Primary specialty

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

Legal business name

MBH PHYSICIAN GROUP -WV PLLC

Practice address

1418 Maccorkle Ave SW
Charleston, WV 25303-1342

Phone

(304) 925-6914

NPI assigned

Sep 13, 2017

Organization subpart

No

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

Authorized official

Name

Cynthia Persily

Title

Ceo

Phone

(304) 348-1421

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1505260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505260800000",
    "number": "1154840841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 CEDARWOOD CIR",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295018497",
            "telephone_number": "843-687-4329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 MACCORKLE AVE SW",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253031342",
            "telephone_number": "304-925-6914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MBH PHYSICIAN GROUP -WV PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-13",
        "last_updated": "2017-09-13",
        "status": "A",
        "authorized_official_last_name": "PERSILY",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-348-1421"
    },
    "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": []
}

• Daniel Christopher Mazzella, CRNA
• MBH Health Center, LLC
• MBH Highland, LLC
• MBH Highland, LLC
• MBH Highland, LLC
• MBH Physician Group -WV PLLC
• Candace A MC Cormick, M.D.
• Michaila Icylene McAnuff
• Ailen McAuley
• Megan McBrayer

• Mental Health Clinic/Center (Including Community Mental Health Center) in Charleston, WV
• Providers in Charleston, WV by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2017; 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.