NPIMap

Organization Active NPI

Blue Mountain Therapy, LLC

  • Behavior Analyst
  • Abingdon, VA
National Provider Identifier
1497330401
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
BLUE MOUNTAIN THERAPY, LLC
Practice address
17507 Lee Hwy
Abingdon, VA 24210-7835
Phone
(276) 525-6043
NPI assigned
Mar 11, 2021
Organization subpart
Yes
Parent organization
BLUE MOUNTAIN THERAPYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Authorized official

Name
Melissa Hope Henderson
Title
HR
Phone
(276) 525-4460

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary
Assistant Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 106E00000X
Behavior TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 106S00000X

Addresses

Primary practice location

17507 Lee Hwy
Abingdon, VA 24210-7835

Mailing address

17507 Lee Hwy
Abingdon, VA 24210-7835
Phone (276) 525-6043

Other practice location 1

27018 Lee Hwy
Abingdon, VA 24211-7512
Phone (276) 525-6043

Other practice location 2

800 E Main St Ste 200
Wytheville, VA 24382-3322
Phone (276) 525-6043

Other practice location 3

440 Park Ave NW
Norton, VA 24273-2114
Phone (276) 525-6043

Other practice location 4

686 Hwy 58 E
Norton, VA 24273
Phone (276) 525-6043

Other names 1

  • Blue Mountain Therapy ABA Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250303001354 VA Part B Supplier - Clinic/Group Practice 4789019944 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Norton, VA; Abingdon, VA; Wytheville, VA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Blue Mountain Therapy LLC6 organizations share this tax ID, including this one
Part of
Blue Mountain Therapy LLC

Other organizations with this tax ID 5

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 9

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": "1615420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630454400000",
    "number": "1497330401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17507 LEE HWY",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242107835",
            "telephone_number": "276-525-6043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17507 LEE HWY",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242107835",
            "telephone_number": "276-525-6043"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27018 Lee Hwy",
            "address_purpose": "LOCATION",
            "city": "Abingdon",
            "state": "VA",
            "postal_code": "242117512",
            "country_code": "US",
            "telephone_number": "276-525-6043",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 E Main St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Wytheville",
            "state": "VA",
            "postal_code": "243823322",
            "country_code": "US",
            "telephone_number": "276-525-6043",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "440 Park Ave NW",
            "address_purpose": "LOCATION",
            "city": "Norton",
            "state": "VA",
            "postal_code": "242732114",
            "country_code": "US",
            "telephone_number": "276-525-6043",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "686 Hwy 58 E",
            "address_purpose": "LOCATION",
            "city": "Norton",
            "state": "VA",
            "postal_code": "24273",
            "country_code": "US",
            "telephone_number": "276-525-6043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BLUE MOUNTAIN THERAPY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BLUE MOUNTAIN THERAPY",
        "enumeration_date": "2021-03-11",
        "last_updated": "2021-09-01",
        "certification_date": "2021-08-17",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "HOPE",
        "authorized_official_title_or_position": "HR",
        "authorized_official_telephone_number": "276-525-4460"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Mountain Therapy ABA",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Blue Mountain Therapy ABA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Abingdon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; 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.