NPIMap

Organization Active NPI

West Central Mental Health Center, Inc.

  • Community/Behavioral Health Agency
  • Canon City, CO
National Provider Identifier
1265565824
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
1306 Issued in CO
Legal business name
WEST CENTRAL MENTAL HEALTH CENTER, INC.
Practice address
3225 Independence Rd
Canon City, CO 81212-9380
Phone
(719) 275-2351
Fax
(719) 269-9386
NPI assigned
Mar 13, 2007
Last updated
May 8, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
WEST CENTRAL INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Authorized official

Name
Mandy Jo Kaisner, LPCNPI 1396877692
Title
Ceo
Phone
(719) 275-2351

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 1668-00 CO
Community/Behavioral Health Agency 251S00000X 1306 CO Primary

Addresses

Primary practice location

3225 Independence Rd
Canon City, CO 81212-9380

Mailing address

3225 Independence Rd
Canon City, CO 81212-9380
Phone (719) 275-2351

Other identifiers 1

IdentifierTypeStateIssuer
04200093MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040326001311 CO Part B Supplier - Clinic/Group Practice 0042102733 Receives reassigned benefits from 20 practitioners
13 other NPIs on this enrollment
Practice locations: Buena Vista, CO; Westcliffe, CO; Salida, CO; Canon City, CO; Leadville, CO

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 27

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.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715126400000",
    "number": "1265565824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3225 INDEPENDENCE RD",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812129380",
            "telephone_number": "719-275-2351",
            "fax_number": "719-269-9386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3225 INDEPENDENCE RD",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812129380",
            "telephone_number": "719-275-2351",
            "fax_number": "719-269-9386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST CENTRAL MENTAL HEALTH CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WEST CENTRAL INC",
        "enumeration_date": "2007-03-13",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A",
        "authorized_official_last_name": "KAISNER",
        "authorized_official_first_name": "MANDY",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "719-275-2351",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "CO",
            "license": "1668-00",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CO",
            "license": "1306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04200093",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canon City, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; 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.