NPI Code Detail JSON Logo

1780479873 NPI number — MOUNTAIN VIEW WELLNESS, LLC

NPI Number: 1780479873
Health Care Provider/Practitioner: MOUNTAIN VIEW WELLNESS, LLC

Information about “1780479873” NPI (MOUNTAIN VIEW WELLNESS, LLC) exists in 1780479873 in HTML format HTML  |  1780479873 in plain Text format TXT  |  1780479873 in PDF (Portable Document Format) PDF  |  1780479873 in an XML format XML  formats.

NPI Number : 1780479873 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1780479873",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "MOUNTAIN VIEW WELLNESS, LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "374 W ALGER ST APT C",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SHERIDAN",
    "MailingAddressStateName": "WY",
    "MailingAddressPostalCode": "82801-3830",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "307-575-1430",
    "MailingAddressFaxNumber": "307-263-7519",
    "FirstLinePracticeLocationAddress": "45 E LOUCKS ST STE 18",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SHERIDAN",
    "PracticeLocationAddressStateName": "WY",
    "PracticeLocationAddressPostalCode": "82801-6328",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "307-575-1430",
    "PracticeLocationAddressFaxNumber": "307-263-7519",
    "EnumerationDate": "04/10/2025",
    "LastUpdateDate": "04/10/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "BEVERLY",
    "AuthorizedOfficialFirstName": "JASZMYNE",
    "AuthorizedOfficialMiddleName": "ASHLEEANN",
    "AuthorizedOfficialTitle": "OWNER/ LPC",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MAE, LPC",
    "AuthorizedOfficialTelephoneNumber": "307-575-1430",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "261QM0850X",
          "TaxonomyName": "Adult Mental Health Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QM0855X",
          "TaxonomyName": "Adolescent and Children Mental Health Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.