NPIMap

Organization Active NPI

Mountainview Services, LLC

Doing business as Ellie Mental Health-West Virginia

  • Clinical Social Worker
  • Morgantown, WV
National Provider Identifier
1235910159
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MOUNTAINVIEW SERVICES, LLC
Doing business as
Ellie Mental Health-West Virginia
Practice address
1206 Suncrest Town Centre Dr
Morgantown, WV 26505-1828
Phone
(724) 554-7759
NPI assigned
Oct 6, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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

Authorized official

Name
Thomas Michael Palko
Title
Owner
Phone
(724) 554-7759

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

1206 Suncrest Town Centre Dr
Morgantown, WV 26505-1828

Mailing address

1774 Jefferson Rd
Jefferson, PA 15344-4157
Phone (724) 554-7759

Other names 1

  • Ellie Mental Health-West Virginia Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240110001450 WV Part B Supplier - Clinic/Group Practice 3870944234 Receives reassigned benefits from 6 practitioners
Practice locations: Bridgeport, WV; Morgantown, WV

National Provider Directory

National Provider Directory

Locations

2000 Jerry Dove Dr
#102
Bridgeport, WV 26330
Phone (304) 244-2471

1206 Suncrest Town Centre Dr
Morgantown, WV 26505
Phone (304) 503-6239

Practitioners & affiliated clinicians

Practitioners 12

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": "1696550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698883200000",
    "number": "1235910159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1774 JEFFERSON RD",
            "city": "JEFFERSON",
            "state": "PA",
            "postal_code": "153444157",
            "telephone_number": "724-554-7759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 SUNCREST TOWN CENTRE DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265051828",
            "telephone_number": "724-554-7759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAINVIEW SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-06",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A",
        "authorized_official_last_name": "PALKO",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "724-554-7759"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ellie Mental Health-West Virginia",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ellie Mental Health-West Virginia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Morgantown, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.