MOUNTAIN COMPREHENSIVE CARE CENTER, INC. (NPI# 1346899275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346899275 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN COMPREHENSIVE CARE CENTER, INC. |
| Practice Address |
104 S Front Ave Prestonsburg KY 41653-1614 |
| Practice Telephone | 6068868572 |
| Practice Fax Number | 6068864433 |
| Mailing Telephone | 6068868572 |
| Mailing Fax Number | 6068864433 |
| Enumeration Date | 2019-09-04 |
| Last Update Date | 2019-09-04 |
| Authorized Official Name | ROXANN CORDIAL (CREDENTIALING) |
| Authorized Official Telephone | 6068868572 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 104 S Front Ave, Prestonsburg, KY 416531614 | 6068868572 | 6068864433 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770121972 | Mountain Comprehensive Care Center, Inc. | Clinic/Center | 210 S Walnut St, Cynthiana, KY 41031-1541 | 2019-12-18 |
| 1265083141 | Mountain Comprehensive Care Center, Inc. | Pharmacy | 242 W Court St, Prestonsburg, KY 41653-7724 | 2019-09-23 |
| 1194224717 | Mountain Comprehensive Care Center, Inc. | Clinic/Center | 26229 Us Highway 119 N Ste A, Belfry, KY 41514-7416 | 2018-02-09 |
| 1114426863 | Mountain Comprehensive Care Center, Inc. | Clinic/Center | 130 Town Hill Rd, Louisa, KY 41230-6389 | 2018-02-08 |
| 1265944060 | Mountain Comprehensive Care Center, Inc. | Clinic/Center | 525 Dotson Branch, Salyersville, KY 41465 | 2017-11-02 |
| 1699386078 | Mountain Comprehensive Care Center, Inc. | Clinic/Center | 838 S Mayo Trl, Paintsville, KY 41240-1384 | 2020-08-11 |
| 1285244244 | Mountain Comprehensive Care Center, Inc. | Clinic/Center | 428 E Main St, Inez, KY 41224-8931 | 2020-08-05 |
| 1295385599 | Mountain Comprehensive Care Center, Inc. | Clinic/Center | 104 S Front Ave, Prestonsburg, KY 41653-1614 | 2019-09-18 |
| 1356990337 | Mountain Comprehensive Care Center, Inc. | Clinic/Center | 104 S Front Ave, Prestonsburg, KY 41653-1614 | 2019-09-11 |
| 1184182180 | Mountain Comprehensive Care Center, Inc. | Clinic/Center | 1110 S Mayo Trl, Paintsville, KY 41240-1273 | 2019-03-08 |
| Street Address |
104 S FRONT AVE |
| City | PRESTONSBURG |
| State | KY |
| Zip Code | 41653-1614 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225020332 | Manmohan Pothuloori | Psychiatry & Neurology | 104 S Front Ave, Prestonsburg, KY 41653-1614 | 2005-08-16 |
| 1982203477 | Tiffany Gipson | Counselor | 104 S Front Ave, Prestonsburg, KY 41653-1614 | 2020-10-26 |
| 1932708427 | Yvonne House | Community Health Worker | 104 S Front Ave, Prestonsburg, KY 41653-1614 | 2020-10-26 |
| 1649879529 | Kari Steele | Registered Nurse | 104 S Front Ave, Prestonsburg, KY 41653-1614 | 2020-10-21 |
| 1730788712 | Megan Stansberry | Community Health Worker | 104 S Front Ave, Prestonsburg, KY 41653-1614 | 2020-10-21 |
| 1235738238 | Ashley Blackburn | Community Health Worker | 104 S Front Ave, Prestonsburg, KY 41653-1614 | 2020-10-21 |
| 1851990824 | Kelsey Sizemore | Community Health Worker | 104 S Front Ave, Prestonsburg, KY 41653-1614 | 2020-10-21 |
| 1538768536 | Anthony Barrett | Community Health Worker | 104 S Front Ave, Prestonsburg, KY 41653-1614 | 2020-10-21 |
| 1790384048 | Lakin Kirk | Counselor | 104 S Front Ave, Prestonsburg, KY 41653-1614 | 2020-10-19 |
| 1568061976 | Shawna Edwards | Community Health Worker | 104 S Front Ave, Prestonsburg, KY 41653-1614 | 2020-10-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568094670 | Commonwealth Community Care Centers, LLC | Obstetrics & Gynecology | 156 North Lake Drive, Prestonburg, KY 41653 | 2020-02-06 |
| 1336781152 | Toni Coleman | Counselor | 104 South Front Ave, Prestonsburg, KY 41653 | 2019-10-14 |
| 1063070043 | Beverly Jane Daniel | Nurse Practitioner | 5230-ky-321#8, Prestonsburg, KY 41653 | 2019-06-04 |
| 1760966519 | Mackenzie Alvarez | Counselor | 104 South Front Avenue, Prestonsburg, KY 41653 | 2018-09-18 |
| 1427409739 | Css Rehab Services | Early Intervention Provider Agency | 165 Ridgewood Drive, Prestonsburg, KY 41653 | 2016-06-28 |
| 1356745509 | Rosanna Mccoy | Counselor | 105 Trimble Chapel Square, Prestonsburg, KY 41653 | 2014-10-17 |
| 1770828766 | Mary Whitney Amburgey | Physical Therapist | 5000 Ky-321, Prestonsburg, KY 41653 | 2012-12-03 |
| 1750648168 | Cynthia Crase | Social Worker | 311 N Arnold Ave Ste 504, Prestonsburg, KY 41653 | 2012-04-23 |
| 1003107566 | Shane Hensley | Pharmacist | 152 Collins Circle, Prestonsburg, KY 41653 | 2011-05-02 |
| 1659607018 | Paul Michael Burchett | Pharmacist | 5291 Ky Rte 321, Prestonsburg, KY 41653 | 2009-10-20 |
| Find all providers in zip 41653 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336614072 | Jason Muzzillo, Pllc | Clinic/Center | 168 E Reynolds Rd Ste 210, Lexington, KY 40517-1365 | 2018-10-09 |
| 1447660089 | Gateway Juvenile Diversion Project, Inc. | Clinic/Center | 37 North Maysville St, Mt Sterlig, KY 40353 | 2014-05-05 |
| 1073941837 | Specialized Alternatives for Families and Youth of Kentucky - Elizabet | Clinic/Center | 708 Westport Rd Ste 102, Elizabethtown, KY 42701-2866 | 2013-10-14 |
| 1538378203 | Rape Victim Services, Inc. | Clinic/Center | 1605 N Friendship Rd, Paducah, KY 42001-8650 | 2007-05-21 |
| 1104966357 | The Arc of Owensboro Inc. | Clinic/Center | 731 Jackson Street, Owensboro, KY 42303 | 2007-02-07 |
| 1336561265 | Couchimhc | Clinic/Center | 2415 Lime Kiln Ln, Suite B, Louisville, KY 40222-3429 | 2014-01-12 |
| 1083988919 | Specialized Alternatives for Families and Youth of Kentucky - Somerset | Clinic/Center | 3540 S Highway 27, Suite 4, Somerset, KY 42501-3026 | 2012-02-23 |
| 1720352651 | Specialized Alternatives for Families and Youth of Kentucky-louisville | Clinic/Center | 1169 Eastern Pkwy, Ste 3364, Louisville, KY 40217-1417 | 2012-02-23 |
| 1053692012 | Awareness and Discovery Group LLC | Clinic/Center | 2 Dortha Ave, Florence, KY 41042-2014 | 2011-09-06 |
| 1154579050 | Family Care Center Clinic | Clinic/Center | 1135 Red Mile Pl, Lexington, KY 40504-1172 | 2008-09-04 |
| Find all providers with the same taxonomy | ||||
| City | PRESTONSBURG |
| Zip Code | 41653 |
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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.