NPIMap

Organization Active NPI

Moundbuilders Guidance Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mount Vernon, OH
National Provider Identifier
1598723728
Registry record updated May 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MOUNDBUILDERS GUIDANCE CENTER, INC.
Practice address
8402 Blackjack Road Ext
Mount Vernon, OH 43050-9193
Phone
(740) 397-0442
Fax
(740) 392-1814
NPI assigned
May 4, 2006
Last updated
May 9, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2008

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

Authorized official

Name
Mr. Patrick C Evans
Title
Ceo
Phone
(740) 788-3400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

8402 Blackjack Road Ext
Mount Vernon, OH 43050-9193

Mailing address

8402 Blackjack Road Ext
Mount Vernon, OH 43050-9193
Phone (740) 397-0442

Other identifiers 3

IdentifierTypeStateIssuer
0200008OtherOHMEDICARE CROSSOVER
MC-26MedicaidOH
2485734OtherOHRISPERDAL

National Provider Directory

National Provider Directory
Tax ID family
Behavioral Healthcare Partners of Central Ohio6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

8402 Blackjack Rd
Mount Vernon, OH 43050
Phone (740) 397-0442

Practitioners & affiliated clinicians

Practitioners 63

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 63

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210291200000",
    "number": "1598723728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8402 BLACKJACK ROAD EXT",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430509193",
            "telephone_number": "740-397-0442",
            "fax_number": "740-392-1814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8402 BLACKJACK ROAD EXT",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430509193",
            "telephone_number": "740-397-0442",
            "fax_number": "740-392-1814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNDBUILDERS GUIDANCE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2008-05-09",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "740-788-3400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE CROSSOVER",
            "identifier": "0200008",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MC-26",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RISPERDAL",
            "identifier": "2485734",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2008; 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.