NPIMap

Organization Active NPI

Psychological Assessment & Intervention Services, LLC

  • Respite Care
  • Dunbar, WV
National Provider Identifier
1477955235
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Respite CareTaxonomy code 385H00000X
License
566 Issued in WV
Legal business name
PSYCHOLOGICAL ASSESSMENT & INTERVENTION SERVICES, LLC
Practice address
1 Dunbar PLZ Ste 100a
Dunbar, WV 25064-3038
Phone
(304) 346-9586
Fax
(304) 344-2169
NPI assigned
Sep 23, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Authorized official

Name
Laura White
Title
WV Director of Operations
Phone
(304) 992-6153

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Respite Care 385H00000X 566 WV Primary

Addresses

Primary practice location

1 Dunbar PLZ Ste 100a
Dunbar, WV 25064-3038

Mailing address

10304 Spotsylvania Ave Ste 300
Fredericksburg, VA 22408-8605
Phone (304) 346-9586

Other identifiers 1

IdentifierTypeStateIssuer
0005412000MedicaidWV

Other names 1

  • Clarvida Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Clarvida2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1 Dunbar Plz
Ste 100A
Dunbar, WV 25064
Phone (304) 766-9830

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1411430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720569600000",
    "number": "1477955235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10304 SPOTSYLVANIA AVE STE 300",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224088605",
            "telephone_number": "304-346-9586",
            "fax_number": "304-344-2169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DUNBAR PLZ STE 100A",
            "city": "DUNBAR",
            "state": "WV",
            "postal_code": "250643038",
            "telephone_number": "304-346-9586",
            "fax_number": "304-344-2169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL ASSESSMENT & INTERVENTION SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-23",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "WV DIRECTOR OF  OPERATIONS",
        "authorized_official_telephone_number": "304-992-6153"
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "WV",
            "license": "566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005412000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarvida",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dunbar, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.