NPIMap

Organization Active NPI

Potomac Highlands Mental Health Guild, Inc.

  • Community/Behavioral Health Agency
  • Petersburg, WV
National Provider Identifier
1992714398
Registry record updated Mar 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
1036-8848 Issued in WV
Legal business name
POTOMAC HIGHLANDS MENTAL HEALTH GUILD, INC.
Practice address
6 Park St
Petersburg, WV 26847-1765
Phone
(304) 257-1155
Fax
(304) 257-1945
NPI assigned
Aug 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2008

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

Authorized official

Name
Mr. S. Craig Curtis
Title
Ceo
Phone
(304) 257-1155

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X 14000 WV
Community/Behavioral Health Agency 251S00000X 1036-8848 WV Primary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 14000 WV

Addresses

Primary practice location

6 Park St
Petersburg, WV 26847-1765

Mailing address

6 Park St
Petersburg, WV 26847-1765
Phone (304) 257-1155

Other identifiers 3

IdentifierTypeStateIssuer
0005473000MedicaidWV
0005473001MedicaidWV
0005473002MedicaidWV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080428000241 WV Part B Supplier - Clinic/Group Practice 0244316123 Receives reassigned benefits from 7 practitioners
Practice locations: Keyser, WV; Romney, WV; Petersburg, WV; Franklin, WV

National Provider Directory

National Provider Directory

Locations

79 Robert C Byrd Industrial Park
Moorefield, WV 26836
Phone (304) 538-2302

245 N Charlevoix Pl
Romney, WV 26757
Phone (304) 822-3897

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206921600000",
    "number": "1992714398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 PARK ST",
            "city": "PETERSBURG",
            "state": "WV",
            "postal_code": "268471765",
            "telephone_number": "304-257-1155",
            "fax_number": "304-257-1945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 PARK ST",
            "city": "PETERSBURG",
            "state": "WV",
            "postal_code": "268471765",
            "telephone_number": "304-257-1155",
            "fax_number": "304-257-1945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTOMAC HIGHLANDS MENTAL HEALTH GUILD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2008-03-31",
        "status": "A",
        "authorized_official_last_name": "CURTIS",
        "authorized_official_first_name": "S.",
        "authorized_official_middle_name": "CRAIG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-257-1155",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "WV",
            "license": "14000",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WV",
            "license": "1036-8848",
            "primary": true
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "WV",
            "license": "14000",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005473000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005473001",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005473002",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Petersburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.