NPIMap

Organization Active NPI

Midland Behavioral Health, Inc.

  • Psychiatry Physician
  • Barboursville, WV
National Provider Identifier
1790080307
Registry record updated Oct 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
14902 Issued in WV
Legal business name
MIDLAND BEHAVIORAL HEALTH, INC.
Practice address
3450 RT. 60 East
Barboursville, WV 25504-1609
Phone
(304) 955-6300
NPI assigned
Jan 13, 2011
Organization subpart
Yes
Parent organization
PRESTERA CENTER FOR MENTAL HEALTH SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 21, 2015

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

Authorized official

Name
Robert Hansen
Title
Executive Director
Phone
(304) 399-1133

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 1213 WV
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 14902 WV Primary
Family Health Clinical Nurse SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 364SF0001X 71510 WV

Addresses

Primary practice location

3450 RT. 60 East
Barboursville, WV 25504-1609

Mailing address

3450 RT. 60 East
Barboursville, WV 25504-1609
Phone (304) 955-6300

National Provider Directory

National Provider Directory
Part of
Prestera Center for Mental Health Services Inc

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1294876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445385600000",
    "number": "1790080307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 RT. 60 EAST",
            "city": "BARBOURSVILLE",
            "state": "WV",
            "postal_code": "255041609",
            "telephone_number": "304-955-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 RT. 60 EAST",
            "city": "BARBOURSVILLE",
            "state": "WV",
            "postal_code": "255041609",
            "telephone_number": "304-955-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDLAND BEHAVIORAL HEALTH, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRESTERA CENTER FOR MENTAL HEALTH SERVICES, INC.",
        "enumeration_date": "2011-01-13",
        "last_updated": "2015-10-21",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "304-399-1133"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "WV",
            "license": "1213",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WV",
            "license": "14902",
            "primary": true
        },
        {
            "code": "364SF0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "WV",
            "license": "71510",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Barboursville, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2015; 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.