Healthcare Provider Details

I. General information

NPI: 1891614046
Provider Name (Legal Business Name): THREE SPRINGS BEHAVIORAL MEDICINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 THREE SPRINGS DR STE 3
WEIRTON WV
26062-3840
US

IV. Provider business mailing address

204 THREE SPRINGS DR STE 3
WEIRTON WV
26062-3840
US

V. Phone/Fax

Practice location:
  • Phone: 304-794-6586
  • Fax: 304-873-4311
Mailing address:
  • Phone: 304-794-6586
  • Fax: 304-873-4311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: PAUL ANTHONY MARINO
Title or Position: MANAGER
Credential: NP
Phone: 304-794-6586