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General NPI Number Information
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NPI Number | 1952804791
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Entity Type | Organization
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Legal Business Name | MOUNTAIN VIEW MENTAL HEALTH, LLC
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Dates
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Enumeration Date | 03/16/2018
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Last Update Date | 12/08/2020
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Provider Practice Location Address
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Address Line | 4233 OLD NILES FERRY RD
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City | MARYVILLE
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State | TN
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Zip | 37801-0643
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Country | US
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Telephone | 865-245-0515
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Fax |
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Provider Business Mailing Address
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Address Line | 576 FOOTHILLS PLZ
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City | MARYVILLE
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State | TN
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Zip | 37801-2305
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Country | US
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Telephone | 865-245-0515
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Fax |
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Authorized Official
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Title or Position | OWNER/NURSE PRACTITONER
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Name | MARY SALERNO
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Credential | APRN
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Telephone | 865-245-0515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 23995
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License Number State | TN
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