Intensive Trauma Recovery LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

INTENSIVE TRAUMA RECOVERY LLC

Practice address

1102 About Town Place
Morgantown, WV 26508

Phone

(800) 755-6105

Fax

(800) 755-6105

NPI assigned

May 18, 2021

Last updated

May 18, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mary Jeanne Carlson

Title

Ceo

Phone

(773) 230-2310

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1621296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621296000000",
    "number": "1386218048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "364 PATTESON DR # 105",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265053202",
            "telephone_number": "773-230-2310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 ABOUT TOWN PLACE",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "26508",
            "telephone_number": "800-755-6105",
            "fax_number": "800-755-6105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTENSIVE TRAUMA RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-18",
        "last_updated": "2021-05-18",
        "certification_date": "2021-04-17",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "JEANNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "773-230-2310"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Inner Strength Counseling
• Kestrel Innes-Wimsatt
• Inside Out Counseling and Assessment Services, PLLC
• Linda Chenoweth Inskeep
• Integrative Counseling Solutions PLLC
• Intensive Trauma Therapy Inc
• Intentional Wellness and Consulting
• Interim Healthcare of Pittsburgh, Inc. (Interim HealthCare of Morgantown)
• Interim Healthcare of Pittsburgh, Inc. (Interim Healthcare of Morgantown)
• Interim Healthcare of Pittsburgh, Inc. (Interim Healthcare of Morgantown)

• Mental Health Clinic/Center (Including Community Mental Health Center) in Morgantown, WV
• Providers in Morgantown, WV by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; 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.