NPIMap

Organization Active NPI

Mulberry Street Management Services, Inc.

  • Case Management Agency
  • Morgantown, WV
National Provider Identifier
1306944236
Registry record updated Aug 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
310 Issued in WV
Legal business name
MULBERRY STREET MANAGEMENT SERVICES, INC.
Practice address
1097 Greenbag Rd
Morgantown, WV 26508-1532
Phone
(304) 291-9066
Fax
(304) 291-2119
NPI assigned
Sep 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2007

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

Authorized official

Name
Ms. Mary S Plevich
Title
Cfo
Phone
(304) 291-9066

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 310 WV Primary
Home Health Agency 251E00000X

Addresses

Primary practice location

1097 Greenbag Rd
Morgantown, WV 26508-1532

Mailing address

1097 Greenbag Rd
Morgantown, WV 26508-1532
Phone (304) 291-9066

Other identifiers 1

IdentifierTypeStateIssuer
0030447003MedicaidWV

Other names 1

  • Coordinating Council for Independent Living Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mulberry Street Management Services Inc10 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.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186617600000",
    "number": "1306944236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1097 GREENBAG RD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265081532",
            "telephone_number": "304-291-9066",
            "fax_number": "304-291-2119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1097 GREENBAG RD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265081532",
            "telephone_number": "304-291-9066",
            "fax_number": "304-291-2119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MULBERRY STREET MANAGEMENT SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-08-09",
        "status": "A",
        "authorized_official_last_name": "PLEVICH",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "304-291-9066",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "WV",
            "license": "310",
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0030447003",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coordinating Council for Independent Living",
            "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 Aug 9, 2007; 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.