Mountain Laurel Wellness LLC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

1978 Issued in WV

Legal business name

MOUNTAIN LAUREL WELLNESS LLC

Practice address

235 High St
Suite 407
Morgantown, WV 26505-5429

Phone

(304) 282-7552

NPI assigned

Feb 19, 2016

Organization subpart

No

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

Authorized official

Name

Jamie Elizabeth Jacobs, LPC, ALPS

Title

Counselor

Phone

(304) 282-7552

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1455840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455840000000",
    "number": "1407215320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 HIGH ST",
            "address_2": "SUITE 407",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265055429",
            "telephone_number": "304-282-7552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 HIGH ST",
            "address_2": "SUITE 407",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265055429",
            "telephone_number": "304-282-7552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN LAUREL WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-19",
        "last_updated": "2016-02-19",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "304-282-7552",
        "authorized_official_credential": "LPC, ALPS"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": "WV",
            "license": "1978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Suzannah Mosley, RPH
• Alvin H Moss, M. D.
• Aron Moss
• Hailey Cameron Mostacciuolo, M.A., PLPC, NCC
• Mariah Mott, MD
• Mountain Ridge Physical Therapy LLC
• Mountain State Mobility
• Mountain State Sleep Center, Inc
• Mountain State Spinal Care
• Mountain State Wellness, PLLC

• Counselor in Morgantown, WV
• Providers in Morgantown, WV by specialty
• Counselor in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2016; 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.