Individual provider Active NPI

Susan Buric, MA LPC

  • Professional Counselor
  • Morgantown, WV
National Provider Identifier
1720167406
Registry record updated Feb 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
258 Issued in WV
Practice address
1193B Pineview Dr
Morgantown Mental Health Associates LLC
Morgantown, WV 26505
Phone
(304) 599-1816
Fax
(304) 599-1459
NPI assigned
Nov 3, 2006
Last updated
Feb 25, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2008

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 258 WV Primary

Addresses

Primary practice location

1193B Pineview Dr
Morgantown Mental Health Associates LLC
Morgantown, WV 26505

Mailing address

1193B Pineview Dr
Morgantown Mental Health Associates LLC
Morgantown, WV 26505
Phone (304) 599-1816

Other identifiers 1

IdentifierTypeStateIssuer
0116779000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
258WVMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Morgantown Mental Health Associates LLC PastSince Aug 1, 1996 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203897600000",
    "number": "1720167406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1193B PINEVIEW DR",
            "address_2": "MORGANTOWN MENTAL HEALTH ASSOCIATES LLC",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "26505",
            "telephone_number": "304-599-1816",
            "fax_number": "304-599-1459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1193B PINEVIEW DR",
            "address_2": "MORGANTOWN MENTAL HEALTH ASSOCIATES LLC",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "26505",
            "telephone_number": "304-599-1816",
            "fax_number": "304-599-1459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURIC",
        "first_name": "SUSAN",
        "credential": "MA LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2008-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WV",
            "license": "258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0116779000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.