Mountaineer Life Enrichment Center, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MOUNTAINEER LIFE ENRICHMENT CENTER, LLC

Practice address

1522 Bunner Ridge Rd
Fairmont, WV 26554-5079

Phone

(304) 373-4678

NPI assigned

Mar 1, 2023

Organization subpart

No

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

Authorized official

Name

Charles Sears, LICSWNPI 1912654823

Title

Clinical Social Worker

Phone

(304) 373-4678

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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.

• Charles Calvin Sears, LICSW

  • Clinical Social Worker
  • Fairmont, WV
  • NPI 1912654823
  NPD Authorized official

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

{
    "created_epoch": "1677628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677628800000",
    "number": "1275232043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1522 BUNNER RIDGE RD",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265545079",
            "telephone_number": "304-373-4678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1522 BUNNER RIDGE RD",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265545079",
            "telephone_number": "304-373-4678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAINEER LIFE ENRICHMENT CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-01",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A",
        "authorized_official_last_name": "SEARS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "304-373-4678",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELF PAY",
            "identifier": "00000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Lynn Mott, CFNP
• Mountain Grace Women's Wellness Center LLC
• Mountain River Physical Therapy, LLC
• Mountain State Physical Therapy LLC (Mountain State Physical Therapy)
• Mountaineer Case Management
• Sierra Michelle Mounts
• Erica Nicole Mouser, MOT/L
• Rachel Moye
• Nancy Moyer
• Yvonne Moyer

• Clinical Social Worker in Fairmont, WV
• Providers in Fairmont, WV by specialty
• Clinical Social Worker in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; 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.