Mountain Community Wellness Center

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

061925 Issued in NY

Legal business name

MOUNTAIN COMMUNITY WELLNESS CENTER

Practice address

210 Court St
Suite 4
Watertown, NY 13601-4546

Phone

(315) 221-4381

Fax

(315) 221-4382

NPI assigned

Jan 21, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Jerry Michael Brown, LCSW-R

Title

Clinical Director

Phone

(315) 221-4381

Specialties & licenses 2

Addresses

Locations

Practitioners 2

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

• Daniel Joseph Childers

  • Social Worker
  • Watertown, NY
  • NPI 1720098981
  NPD (past)
• Arun R Kunwar, MD

  • Psychiatry Physician
  • Central Square, NY
  • NPI 1669422325
  NPD (past)

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

{
    "created_epoch": "1327104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327104000000",
    "number": "1619248762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 COURT ST",
            "address_2": "SUITE 4",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136014546",
            "telephone_number": "315-221-4381",
            "fax_number": "315-221-4382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 COURT ST",
            "address_2": "SUITE 4",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136014546",
            "telephone_number": "315-221-4381",
            "fax_number": "315-221-4382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN COMMUNITY WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-21",
        "last_updated": "2012-01-21",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "315-221-4381",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW-R"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "061925",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel C Morgia, LCSW
• Deborah Morrell
• Linda M Moser, ANP
• Penny Mosher, MSW INTERN
• Donald W Mott, LCSW-R
• Mountain Medical of Watertown
• Sarabrooke Mowery, PA-C
• Megan Storms Moyle, PT, DPT
• Monica Sophia Mucalov, OD
• Christopher Michael Mueller, PA-C

• Clinical Social Worker in Watertown, NY
• Providers in Watertown, 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 Jan 21, 2012; 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.