MSRC, LLC (NPI# 1194294587) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194294587 |
| Entity Type | Organization |
| Organization Name | MSRC, LLC |
| Other Organization Name | MOUNTAIN STATE RECOVERY CENTER |
| Practice Address |
102 Patrick Street Plz Charleston WV 25387-2444 |
| Mailing Address |
8 River Walk Mall South Charleston WV 25303-1026 |
| Practice Telephone | 3049419779 |
| Enumeration Date | 2018-11-15 |
| Last Update Date | 2020-08-14 |
| Authorized Official Name | JOSHUA GALIBRAITH (CEO) |
| Authorized Official Telephone | 3049419779 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 291U00000X | Clinical Medical Laboratory | Laboratories | ||
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Other Name | Type Code |
|---|---|
| Mountain State Recovery Center | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 650 Washington Ave, Huntington, WV 257011042 | 3042333200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982268405 | Msrc, LLC | Clinic/Center | 102 Patrick Street Plz, Charleston, WV 25387-2444 | 2019-04-30 |
| 1184288623 | Msrc, LLC | Clinical Medical Laboratory | 102 Patrick Street Plz, Charleston, WV 25387-2444 | 2019-04-30 |
| Street Address |
102 PATRICK STREET PLZ |
| City | CHARLESTON |
| State | WV |
| Zip Code | 25387-2444 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043608326 | Joseph Shaffer | Counselor | 102 Patrick Street Plz, Charleston, WV 25387-2444 | 2015-01-08 |
| 1003415597 | Loretta Rogers | Peer Specialist | 102 Patrick Street Plz, Charleston, WV 25387-2444 | 2020-10-26 |
| 1538773221 | Kathryn Paige Hauldren | Social Worker | 102 Patrick Street Plz, Charleston, WV 25387-2444 | 2020-09-01 |
| 1447862768 | Robert Aaron Burton | Peer Specialist | 102 Patrick Street Plz, Charleston, WV 25387-2444 | 2020-08-18 |
| 1902422066 | Tanya Freeman | Counselor | 102 Patrick Street Plz, Charleston, WV 25387-2444 | 2020-06-24 |
| 1548884075 | Kenneth Brown | Social Worker | 102 Patrick Street Plz, Charleston, WV 25387-2444 | 2020-06-01 |
| 1831711134 | Regina Veltri | Peer Specialist | 102 Patrick Street Plz, Charleston, WV 25387-2444 | 2020-05-11 |
| 1619599024 | Patrick Brown | Peer Specialist | 102 Patrick Street Plz, Charleston, WV 25387-2444 | 2020-05-08 |
| 1629699434 | Autumn Renee Mccraw | Peer Specialist | 102 Patrick Street Plz, Charleston, WV 25387-2444 | 2020-05-04 |
| 1841825221 | Brandy Nicole Swift | Peer Specialist | 102 Patrick Street Plz, Charleston, WV 25387-2444 | 2020-03-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679792493 | Letitia Elaine Tierney | Internal Medicine | Familycare Health Center, 116 N. Hills Plaza, Charleston, WV 25387 | 2007-04-24 |
| 1285960856 | Holly R. Murriner | Physician Assistant | 116 Hills Plz, Charleston, WV 25387 | 2009-11-02 |
| 1427661651 | James Michael Adkins | Technician | 1029 Nease Dr, Charleston, WV 25387-1007 | 2020-08-27 |
| 1578964474 | Resilience Home Care Services, LLC | Home Health | 3700 Washington St W, Charleston, WV 25387-1121 | 2014-09-10 |
| 1205448610 | Christiana E Sovine | Technician | 3902 Washington St W, Charleston, WV 25387-1123 | 2020-08-18 |
| 1245841360 | Nellie Mae Ford | Technician | 802 N Hills Dr, Charleston, WV 25387-1230 | 2020-08-12 |
| 1255941316 | Itai Gravely | Technician | 1863 Sugar Creek Dr, Charleston, WV 25387-1344 | 2020-08-04 |
| 1437513538 | Paula Mooney | Social Worker | 862 Hanna Dr, Charleston, WV 25387-1402 | 2016-04-05 |
| 1952649071 | Enact, Inc. | Case Management | 1701 5th Ave Ste 7, Charleston, WV 25387-1900 | 2013-01-24 |
| 1609045400 | Womencare, Inc | Clinic/Center | 1701 5th Ave, Charleston, WV 25387-1900 | 2008-02-26 |
| Find all providers in zip 25387 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215541669 | Myndspace Mental Health Education & Consulting, LLC | Community/Behavioral Health | 111 Bantry Cir, Charleston, SC 29414-8089 | 2020-09-03 |
| 1467997650 | The Underprivileged Children Foundation Inc. | Community/Behavioral Health | 716 Lee St E Ste 201, Charleston, WV 25301-1707 | 2016-12-27 |
| 1669824561 | Advantage | Community/Behavioral Health | 606 Fort Hill Dr, Charleston, WV 25314-1070 | 2016-07-05 |
| 1821458928 | Wv Institute for Spirituliaty | Community/Behavioral Health | 1601 Virginia St E, Charleston, WV 25311-2113 | 2016-03-02 |
| 1619349453 | Star, LLC | Community/Behavioral Health | 1864 Greenmore Dr, Charleston, SC 29407-3520 | 2015-10-20 |
| 1144617325 | Alliance for Change, LLC | Community/Behavioral Health | 1335 Vine St, Charleston, SC 29407-6437 | 2015-04-24 |
| 1659763001 | C&c Conversations LLC | Community/Behavioral Health | 263 King St, B, Charleston, SC 29401-1420 | 2015-02-23 |
| 1073922555 | Truliant Health Systems LLC | Community/Behavioral Health | 1535 Sam Rittenberg Blvd, Suite C, Charleston, SC 29407-4124 | 2014-08-08 |
| 1912257924 | New Horizons Therapy, LLC | Community/Behavioral Health | 2587 Ashley River Rd, Charleston, SC 29414-4613 | 2012-09-17 |
| 1376814814 | Grant and Ramsey Behavioral Health | Community/Behavioral Health | 7934 Red Birch Cir, Charleston, SC 29418-3190 | 2012-01-13 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 25387 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.