Martin Behavioral Health

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

1011-4283 Issued in WV

Legal business name

MARTIN BEHAVIORAL HEALTH

Practice address

521 Market St
Parkersburg, WV 26101-5150

Phone

(304) 424-3457

Fax

(304) 422-1025

NPI assigned

May 17, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Thomas Richard Martin, BA

Title

President

Phone

(304) 424-3457

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255548186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 MARKET ST",
            "address_2": "BOX 1",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261015150",
            "telephone_number": "304-424-3457",
            "fax_number": "304-422-1025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 MARKET ST",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261015150",
            "telephone_number": "304-424-3457",
            "fax_number": "304-422-1025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-424-3457",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BA"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "WV",
            "license": "1011-4283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810008597",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Destiny Marshall
• Justin Marshall, P.R.S.S
• Pamela Marshall
• Raseann Marte
• Kelli Reddecliff Marteney, MA, PSYCHOLOGY
• Alexis Martin
• Cami Martin
• Danielle R Martin, BA
• James Martin, AAS
• Sheila B Martin

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Parkersburg, WV
• Providers in Parkersburg, WV by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.