Healthcare Provider Details

I. General information

NPI: 1861930836
Provider Name (Legal Business Name): JOSEPH MICHAEL MOUNTS M.ED., AADC, LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2017
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 DINGESS ST
LOGAN WV
25601-3617
US

IV. Provider business mailing address

99 CRACKER BARREL DR STE 100
BARBOURSVILLE WV
25504-1650
US

V. Phone/Fax

Practice location:
  • Phone: 304-525-7851
  • Fax: 304-525-1073
Mailing address:
  • Phone: 304-525-7851
  • Fax: 304-697-1251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number2440
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2440
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: