Organization Active NPI

Park Valley Behavioral Health Care, PLLC

  • Psychiatry Physician
  • Wheeling, WV
National Provider Identifier
1457357261
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
16918 Issued in WV
Legal business name
PARK VALLEY BEHAVIORAL HEALTH CARE, PLLC
Practice address
32 20TH St Ste 500
Wheeling, WV 26003-3747
Phone
(304) 218-2023
Fax
(304) 218-2026
NPI assigned
Jun 27, 2005
Last updated
Mar 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Authorized official

Name
Alfredo A Aguirre, M.D.NPI 1841296654
Title
Owner
Phone
(304) 218-2023

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 16918 WV Primary

Addresses

Primary practice location

32 20TH St Ste 500
Wheeling, WV 26003-3747

Mailing address

32 20TH St Ste 500
Wheeling, WV 26003-3747
Phone (304) 218-2023

Other identifiers 1

IdentifierTypeStateIssuer
0204413000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100902000561 WV Part B Supplier - Clinic/Group Practice 3274657895 Receives reassigned benefits from 5 practitioners
Practice locations: Wheeling, WV

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D2070902Park Valley Behavioral Health Care32 20TH Street, Suite 500, Wheeling, WV 26003Certificate of waiverDec 29, 2027

National Provider Directory

National Provider Directory

Locations

2000 Eoff St
#704
Wheeling, WV 26003
Phone (304) 234-8596

2000 Eoff St
Ste 704
Wheeling, WV 26003
Phone (304) 234-8596

32 20th St
Ste 500
Wheeling, WV 26003
Phone (304) 218-2023

91 Zane St
Wheeling, WV 26003
Phone (304) 243-0366

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616457600000",
    "number": "1457357261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 20TH ST STE 500",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260033747",
            "telephone_number": "304-218-2023",
            "fax_number": "304-218-2026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 20TH ST STE 500",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260033747",
            "telephone_number": "304-218-2023",
            "fax_number": "304-218-2026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK VALLEY BEHAVIORAL HEALTH CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-27",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A",
        "authorized_official_last_name": "AGUIRRE",
        "authorized_official_first_name": "ALFREDO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-218-2023",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WV",
            "license": "16918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0204413000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheeling, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.