NPIMap

Organization Active NPI

Logan-Mingo Area Mental Health, Inc

Doing business as Mountain Laurel Integrated Healthcare

  • Pharmacy
  • Logan, WV
National Provider Identifier
1205525276
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
LOGAN-MINGO AREA MENTAL HEALTH, INC
Doing business as
Mountain Laurel Integrated Healthcare
Practice address
174 Lmah Center Rd
Logan, WV 25601-4058
Phone
(304) 792-7130
Fax
(304) 896-5184
NPI assigned
May 4, 2023
Last updated
Mar 11, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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

Authorized official

Name
Angela L Robertson
Title
Finance Director
Phone
(304) 792-7130

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary

Addresses

Primary practice location

174 Lmah Center Rd
Logan, WV 25601-4058

Mailing address

PO Box 176
Logan, WV 25601-0176
Phone (304) 792-7130

Other identifiers 2

IdentifierTypeStateIssuer
5059060OtherNCPDP
SP0552603OtherWVPHARMACY LICENSE

Other names 1

  • Mountain Laurel Integrated Healthcare Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Logan Mingo Area Mental Health10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

174 Lmah Center Rd
Logan, WV 25601
Phone 3047927130 ext. 1027

NPI Registry JSON

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

{
    "created_epoch": "1683158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773187200000",
    "number": "1205525276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 176",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256010176",
            "telephone_number": "304-792-7130",
            "fax_number": "304-896-5184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 LMAH CENTER RD",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256014058",
            "telephone_number": "304-792-7130",
            "fax_number": "304-896-5184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN-MINGO AREA MENTAL HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-04",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "304-792-7130"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "5059060",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE",
            "identifier": "SP0552603",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain Laurel Integrated Healthcare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mountain Laurel Integrated Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Logan, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2026; 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.