Individual provider Active NPI

Tina L Nibert - Myers, MA

  • Professional Counselor
  • Clay, WV
National Provider Identifier
1659463479
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1562 Issued in WV
Practice address
122 Center St
Clay, WV 25043-7046
Phone
(304) 587-7301
NPI assigned
Sep 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1562 WV Primary

Addresses

Primary practice location

122 Center St
Clay, WV 25043-7046

Mailing address

PO Box 4009
Charleston, WV 25364-4009
Phone (304) 348-1288

Other practice location 1

1418A MacCorkle Ave SW
Charleston, WV 25303
Phone (304) 348-1288

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250618002256 WV Practitioner - Mental Health Counselor 8224549944 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
1562WVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia Inc CurrentSince May 1, 2025 Accepting new patients
Community Care of West Virginia, Inc. CurrentSince May 1, 2025 Accepting new patients

Locations

37 W Main St
Buckhannon, WV 26201
Phone (304) 472-1712

Interoperability endpoints

  • Direct secure messaging: tina.nibert-myers.1@4803.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1659463479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4009",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253644009",
            "telephone_number": "304-348-1288",
            "fax_number": "304-348-1262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 CENTER ST",
            "city": "CLAY",
            "state": "WV",
            "postal_code": "250437046",
            "telephone_number": "304-587-7301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1418A MacCorkle Ave SW",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "25303",
            "country_code": "US",
            "telephone_number": "304-348-1288",
            "fax_number": "304-348-1262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIBERT - MYERS",
        "first_name": "TINA",
        "middle_name": "L",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WV",
            "license": "1562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clay, WV

Sources for this page

Verify at the official NPI Registry.