NPIMap

Organization Active NPI

Williamson Health & Wellness Center Inc

Doing business as Williamson Health & Wellness Center -Licensed Behavioral Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Williamson, WV
National Provider Identifier
1942840384
Registry record updated Jun 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
WILLIAMSON HEALTH & WELLNESS CENTER INC
Doing business as
Williamson Health & Wellness Center -Licensed Behavioral Health Center
Practice address
104 Logan St Ste B
Williamson, WV 25661-3606
Phone
(304) 236-5902
Fax
(855) 487-4047
NPI assigned
Jan 14, 2020
Last updated
Jun 2, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
WILLIAMSON HEALTH & WELLNESS CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 2, 2023

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

Authorized official

Name
Christopher Donovan Beckett, DONPI 1174575898
Title
Ceo
Phone
(304) 236-5902

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

104 Logan St Ste B
Williamson, WV 25661-3606

Mailing address

PO Box 2080
Williamson, WV 25661-2080
Phone (304) 236-5902

Other names 1

  • Williamson Health & Wellness Center -Licensed Behavioral Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210308001675 WV Part B Supplier - Clinic/Group Practice 5395972996 Receives reassigned benefits from 3 practitioners
Practice locations: Williamson, WV

Other NPIs with the same Medicare PAC ID 14

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Williamson Health and Well18 organizations share this tax ID, including this one
Part of
Williamson Health and Well

Other organizations with this tax ID 17

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

View all 17

Locations

104 Logan St
Ste B
Williamson, WV 25661

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Williamson Health & Wellness Center- Behavioral Medicine ClinicWilliamson, WV, CCN 510094 Hospital 5% Or Greater Direct Ownership Interest (100%) May 31, 2020
Williamson Health & Wellness Center IncWilliamson, WV, CCN 511032 Federally qualified health center Operational/Managerial Control Sep 3, 2013
Williamson Health & Wellness Center-Matewan PK-8Matewan, WV, CCN 581078 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2024

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 32

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.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1578960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685664000000",
    "number": "1942840384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2080",
            "city": "WILLIAMSON",
            "state": "WV",
            "postal_code": "256612080",
            "telephone_number": "304-236-5902",
            "fax_number": "855-487-4047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 LOGAN ST STE B",
            "city": "WILLIAMSON",
            "state": "WV",
            "postal_code": "256613606",
            "telephone_number": "304-236-5902",
            "fax_number": "855-487-4047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAMSON HEALTH & WELLNESS CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WILLIAMSON HEALTH & WELLNESS CENTER INC",
        "enumeration_date": "2020-01-14",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A",
        "authorized_official_last_name": "BECKETT",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "DONOVAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-236-5902",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Williamson Health & Wellness Center -Licensed Behavioral Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Williamson Health & Wellness Center -Licensed Behavioral Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Williamson, WV

Sources for this page

Verify at the official NPI Registry.