Mountain Mental Health Group

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MOUNTAIN MENTAL HEALTH GROUP

Practice address

120 Schuyler St
Boonville, NY 13309-1005

Phone

(315) 942-4252

Fax

(315) 942-3207

NPI assigned

Aug 17, 2005

Organization subpart

No

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

Authorized official

Name

Barbara Rice, LCSWNPI 1457343121

Title

General Partner

Phone

(315) 942-4252

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 3

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

• Timothy Francis Dowling, LCSW

  • Clinical Social Worker
  • Boonville, NY
  • NPI 1154489813
  Medicare reassignment NPD
• Barbara Rice, LCSW

  • Clinical Social Worker
  • Boonville, NY
  • NPI 1457343121
  NPD (past) Authorized official
• Susan Elizabeth Gydesen, LCSW

  • Clinical Social Worker
  • Boonville, NY
  • NPI 1144431511
  NPD (past)

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487646279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 211",
            "city": "BOONVILLE",
            "state": "NY",
            "postal_code": "133090211",
            "telephone_number": "315-942-4252",
            "fax_number": "315-942-3207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 SCHUYLER ST",
            "city": "BOONVILLE",
            "state": "NY",
            "postal_code": "133091005",
            "telephone_number": "315-942-4252",
            "fax_number": "315-942-3207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN MENTAL HEALTH GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RICE",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "GENERAL PARTNER",
        "authorized_official_telephone_number": "315-942-4252",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica Mazur, RPH
• Melanie Saber LCSW, PLLC
• Ann F Mellen, FNP
• Andrew J Milone, PA
• Elaine Marie Moore, DPT
• Melissa M Muha, FNP
• Sushma Sapkota Pandey, MD
• Todd M Podkowka, D.O.
• Shaylagh Randall, BS
• Corrine Elizabeth Rauscher, FNP-BC

• Clinical Social Worker in Boonville, NY
• Providers in Boonville, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.