Organization Active NPI

MGH Healthcare, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Warren, OH
National Provider Identifier
1184321341
Registry record updated Sep 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MGH HEALTHCARE, LLC
Practice address
321 Niles Cortland Rd NE Ste B-C
Warren, OH 44484-1974
Phone
(330) 355-3234
Fax
(330) 975-6343
NPI assigned
Feb 8, 2023
Last updated
Sep 22, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2023

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

Authorized official

Name
Dr. Mary Grace Hall, DNP, PMHNP-BC, FNP-CNPI 1831505577
Title
President/Owner/Prescriber
Phone
(330) 355-3234

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

Addresses

Primary practice location

321 Niles Cortland Rd NE Ste B-C
Warren, OH 44484-1974

Mailing address

321 Niles Cortland Rd NE Ste B-C
Warren, OH 44484-1974
Phone (330) 355-3234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230420002244 OH Part B Supplier - Clinic/Group Practice 5193180446 Receives reassigned benefits from 6 practitioners
Practice locations: Warren, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2319409MGH Healthcare, LLC321 Niles Cortland Road NE, Suite BC, Warren, OH 44484Certificate of waiverFeb 26, 2027

National Provider Directory

National Provider Directory

Locations

321 Niles Cortland Rd NE
Warren, OH 44484
Phone (330) 609-5588

321 Niles Cortland Rd NE
Ste Bc
Warren, OH 44484
Phone (330) 355-3234

985 Churchill Hubbard Rd
Youngstown, OH 44505
Phone (330) 333-4027

985 Churchill Hubbard Rd
Ste 10
Youngstown, OH 44505

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1675814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695340800000",
    "number": "1184321341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 NILES CORTLAND RD NE STE B-C",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444841974",
            "telephone_number": "330-355-3234",
            "fax_number": "330-975-6343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 NILES CORTLAND RD NE STE B-C",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444841974",
            "telephone_number": "330-355-3234",
            "fax_number": "330-975-6343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MGH HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-08",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "GRACE",
        "authorized_official_title_or_position": "PRESIDENT/OWNER/PRESCRIBER",
        "authorized_official_telephone_number": "330-355-3234",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, PMHNP-BC, FNP-C"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.