MEDICARE: ASPEN GROVE MENTAL HEALTH PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1699472969
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASPEN GROVE MENTAL HEALTH PLLC

Provider Business Mailing Address
First Line	:	106 HIGH POINT DR
Second Line	:
City	:	FAIRMONT
State	:	WV
Zip	:	26554-4369
Country	:	US
Telephone Number	:	719-204-3633
Fax Number	:	719-249-4018

Provider Business Practice Location Address
First Line	:	235 HIGH ST STE 816
Second Line	:
City	:	MORGANTOWN
State	:	WV
Zip	:	26505-5448
Country	:	US
Telephone Number	:	218-838-4316
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ASHLEY NIEMANN
Credential	:	LMFT
Telephone Number	:	719-204-3633

Provider Enumeration Date	:	02/07/2023
Last Update Date	:	02/16/2026

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