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General NPI Number Information
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NPI Number | 1619873213
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Entity Type | Organization
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Legal Business Name | LOGAN MINGO AREA MENTAL HEALTH
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Dates
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Enumeration Date | 10/19/2026
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Last Update Date | 11/03/2026
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Provider Practice Location Address
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Address Line | 872 ROUTE 65
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City | WILLIAMSON
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State | WV
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Zip | 25661-7497
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Country | US
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Telephone | 304-792-7130
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Fax | 304-896-5184
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Provider Business Mailing Address
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Address Line | PO BOX 176
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City | LOGAN
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State | WV
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Zip | 25601-0176
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Country | US
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Telephone | 304-792-7130
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Fax | 304-896-5124
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Authorized Official
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Title or Position | FINANCE DIRECTOR
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Name | ANGELA L ROBERTSON
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Credential |
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Telephone | 304-792-7130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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