Mount Prospect Academy, Inc.

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

Legal business name

MOUNT PROSPECT ACADEMY, INC.

Practice address

350 Main St
Plymouth, NH 03264-4518

Phone

(603) 536-1102

Fax

(603) 536-3074

NPI assigned

Jun 11, 2007

Last updated

Aug 20, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jay T Wolter

Title

President

Phone

(603) 353-9102

Specialties & licenses 4

Addresses

Other identifiers 2

Tax ID family

Mount Prospect Academy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Mount Prospect Academy

  • Mental Health Counselor
  • Keene, NH
  • NPI 1568057990
  NPD tax ID

Locations

Practitioners 1

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.

• Mackenzie Brooks, LICSW

  • Clinical Social Worker
  • Plymouth, NH
  • NPI 1508476920
  NPD (past)

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629417600000",
    "number": "1720281264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 325",
            "city": "ORFORD",
            "state": "NH",
            "postal_code": "037770325",
            "telephone_number": "603-353-9102",
            "fax_number": "603-353-9412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 MAIN ST",
            "city": "PLYMOUTH",
            "state": "NH",
            "postal_code": "032644518",
            "telephone_number": "603-536-1102",
            "fax_number": "603-536-3074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT PROSPECT ACADEMY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-11",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A",
        "authorized_official_last_name": "WOLTER",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "603-353-9102"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30832240",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30854897",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Constance Ann Morrison, ATTORNEY NP
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• Todd Michael Mosenthal, DC
• Risa Jane Mrozowski, PHARMD, RPH
• Alec Muise
• Lynn M Murray, RN
• Paul S Musco, M.D.
• Jeffrey Leo Nadeau, ATC

• Emotionally Disturbed Childrens' Residential Treatment Facility in Plymouth, NH
• Providers in Plymouth, NH by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2021; 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.