NPIMap

Organization Active NPI

Winchester Community Mental Health Center, Inc.

  • Psychiatry Physician
  • Winchester, VA
National Provider Identifier
1457593188
Registry record updated Mar 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
WINCHESTER COMMUNITY MENTAL HEALTH CENTER, INC.
Practice address
36 Ricketts Dr
Winchester, VA 22601-3676
Phone
(540) 535-1112
Fax
(540) 535-1155
NPI assigned
Mar 26, 2009
Last updated
Mar 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2023

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

Authorized official

Name
Evelyn PuigNPI 1336493592
Title
President
Phone
(540) 535-1112

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 8

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Mental Health Counselor 101YM0800X NU
Professional Counselor 101YP2500X NU
Clinical Social Worker 1041C0700X NU
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X NU
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

36 Ricketts Dr
Winchester, VA 22601-3676

Mailing address

36 Ricketts Dr
Winchester, VA 22601-3676
Phone (540) 535-1112

Other practice location 1

105 Stony Pointe Way Ste 210
Strasburg, VA 22657-2672
Phone (540) 535-1112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, WV3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20100615000207 VA Part A Provider - Community Mental Health Center 9032249214 Practice locations: Winchester, VA
O20110314000792 VA Part B Supplier - Clinic/Group Practice 9032249214 Receives reassigned benefits from 19 practitioners
Practice locations: Strasburg, VA; Winchester, VA
O20150218000089 WV Part B Supplier - Clinic/Group Practice 9032249214 Receives reassigned benefits from 6 practitioners
Practice locations: Inwood, WV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1457593188. Details of each certification follow.

  • CCN 494611 Community mental health center · Active · Name & address match · Details

Community mental health center certification: CCN 494611

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
WINCHESTER COMMUNITY MENTAL HEALTH CENTER, INC
Certification status
Active
Provider type (POS)
Community mental health center
Participating since
Oct 17, 2011
Last certification
Mar 31, 2026
Ownership / control type
For profit – individual
Facility address
36 Ricketts Drive
Winchester, VA 22601

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
49D2084963Winchester Community Mental Health Center, Inc36 Ricketts Drive, Winchester, VA 22601Certificate of waiverOct 5, 2026
49D2250701Winchester Community Mental Health Center Inc105 Stony Pointe Way Suite 210, Strasburg, VA 22657Certificate of waiverJan 27, 2028

National Provider Directory

National Provider Directory
Tax ID family
Winchester Community Mental3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

20B Ricketts Dr
Winchester, VA 22601
Phone (540) 535-1112

89 Hovatter Dr
Inwood, WV 25428
Phone (305) 218-1894

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 31

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 31

NPI Registry JSON

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

{
    "created_epoch": "1238025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679270400000",
    "number": "1457593188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 RICKETTS DR",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226013676",
            "telephone_number": "540-535-1112",
            "fax_number": "540-535-1155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 RICKETTS DR",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226013676",
            "telephone_number": "540-535-1112",
            "fax_number": "540-535-1155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Stony Pointe Way Ste 210",
            "address_purpose": "LOCATION",
            "city": "Strasburg",
            "state": "VA",
            "postal_code": "226572672",
            "country_code": "US",
            "telephone_number": "540-535-1112",
            "fax_number": "540-535-1155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WINCHESTER COMMUNITY MENTAL HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-26",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A",
        "authorized_official_last_name": "PUIG",
        "authorized_official_first_name": "EVELYN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "540-535-1112"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

Verify at the official NPI Registry.