NPIMap

Organization Active NPI

Mountain Valley Mental Health, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Arvada, CO
National Provider Identifier
1578036679
Registry record updated Jan 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MOUNTAIN VALLEY MENTAL HEALTH, LLC
Practice address
5400 Ward Rd Building V
Suite 110
Arvada, CO 80002
Phone
(720) 727-2690
Fax
(720) 727-2691
NPI assigned
Jan 10, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2019

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

Authorized official

Name
Peter J Dahlberg, PMHNPNPI 1013311216
Title
Owner
Phone
(720) 727-2690

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
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

5400 Ward Rd Building V
Suite 110
Arvada, CO 80002

Mailing address

4380 S Monaco St Unit 3013
Denver, CO 80237-3499
Phone (720) 727-2690

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190401001281 CO Part B Supplier - Clinic/Group Practice 7214278241 Receives reassigned benefits from 4 practitioners
Practice locations: Arvada, CO

National Provider Directory

National Provider Directory

Locations

5400 Ward Rd
Bldg 5-110
Arvada, CO 80002

5400 Ward Rd
Bldg V
Arvada, CO 80002
Phone (720) 688-6372

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": "1547078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547078400000",
    "number": "1578036679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4380 S MONACO ST UNIT 3013",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802373499",
            "telephone_number": "720-727-2690",
            "fax_number": "720-727-2691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 WARD RD BUILDING V",
            "address_2": "SUITE 110",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "80002",
            "telephone_number": "720-727-2690",
            "fax_number": "720-727-2691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN VALLEY MENTAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-10",
        "last_updated": "2019-01-10",
        "status": "A",
        "authorized_official_last_name": "DAHLBERG",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-727-2690",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arvada, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2019; 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.