Healthcare Provider Details

I. General information

NPI: 1912964347
Provider Name (Legal Business Name): SOUTHWESTERN VIRGINIA MENTAL HEALTH INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 BAGLEY CIRCLE
MARION VA
24354-3102
US

IV. Provider business mailing address

340 BAGLEY CIRCLE
MARION VA
24354-3102
US

V. Phone/Fax

Practice location:
  • Phone: 276-783-1200
  • Fax: 276-783-1242
Mailing address:
  • Phone: 276-783-1200
  • Fax: 276-783-1242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA MCCLASKEY
Title or Position: FACILITY DIRECTOR
Credential: PHD
Phone: 276-783-1201