NPIMap

Organization Active NPI

Family Service of Marion & Harrison Counties Inc

  • Community/Behavioral Health Agency
  • Fairmont, WV
National Provider Identifier
1356455091
Registry record updated May 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
FAMILY SERVICE OF MARION & HARRISON COUNTIES INC
Practice address
1313 Locust Ave
Suite 101
Fairmont, WV 26554-1435
Phone
(304) 366-4750
Fax
(304) 366-4753
NPI assigned
Aug 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2022

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

Authorized official

Name
Mrs. Carolyn Jones, MSW
Title
Executive Director
Phone
(304) 366-4750

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 129 WV
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1313 Locust Ave
Suite 101
Fairmont, WV 26554-1435

Mailing address

1313 Locust Ave
Suite 101
Fairmont, WV 26554-1435
Phone (304) 366-4750

Other identifiers 5

IdentifierTypeStateIssuer
0023793001MedicaidWV
0023793003MedicaidWV
0023793000MedicaidWV
0023793004MedicaidWV
001709325OtherWVBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory
Tax ID family
Family Service of Marion Harrison Counties Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1313 Locust Ave
Ste 101
Fairmont, WV 26554

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651795200000",
    "number": "1356455091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 LOCUST AVE",
            "address_2": "SUITE 101",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265541435",
            "telephone_number": "304-366-4750",
            "fax_number": "304-366-4753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 LOCUST AVE",
            "address_2": "SUITE 101",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265541435",
            "telephone_number": "304-366-4750",
            "fax_number": "304-366-4753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY SERVICE OF MARION & HARRISON COUNTIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2022-05-06",
        "certification_date": "2022-05-06",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "304-366-4750",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WV",
            "license": "129",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0023793001",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0023793003",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0023793000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0023793004",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "001709325",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairmont, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2022; 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.