Healthcare Provider Details

I. General information

NPI: 1306242540
Provider Name (Legal Business Name): MOUNTAINEER PSYCHOLOGICAL SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2014
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CORPORATE DR
MORGANTOWN WV
26501-4580
US

IV. Provider business mailing address

100 CORPORATE DR
MORGANTOWN WV
26501-4580
US

V. Phone/Fax

Practice location:
  • Phone: 304-241-1766
  • Fax: 304-381-2648
Mailing address:
  • Phone: 304-241-1766
  • Fax: 304-381-2648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number926
License Number StateWV
# 3
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number926
License Number StateWV
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number926
License Number StateWV

VIII. Authorized Official

Name: DR. JENNIFER GURIEL MYERS
Title or Position: PSYCHOLOGIST/OWNER
Credential: PH.D.
Phone: 304-241-1766