| Midland Behavioral Health, Inc. | |
|
3450 Rt. 60 East Barboursville WV 25504-1609 | |
| (304) 955-6300 | |
| Not Available |
| Full Name | Midland Behavioral Health, Inc. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3450 Rt. 60 East, Barboursville, West Virginia |
| Authorized Official Name and Position | Robert Hansen (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3043991133 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midland Behavioral Health, Inc. 3450 Rt. 60 East Barboursville WV 25504-1609 Ph: (304) 955-6300 | Midland Behavioral Health, Inc. 3450 Rt. 60 East Barboursville WV 25504-1609 Ph: (304) 955-6300 |
| NPI Number | 1790080307 |
|---|---|
| Provider Enumeration Date | 01/13/2011 |
| Last Update Date | 10/21/2015 |
| Medicare PECOS PAC ID | 6406030527 |
|---|---|
| Medicare Enrollment ID | O20110413000702 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790080307 | NPI | - | NPPES |
| Provider Name | David J Humphreys |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295778660 PECOS PAC ID: 6204825425 Enrollment ID: I20080911000420 |
| Provider Name | April Michele Baisden |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376763144 PECOS PAC ID: 7911058367 Enrollment ID: I20090625000446 |
| Provider Name | Matthew C Kellar |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285058453 PECOS PAC ID: 3971736919 Enrollment ID: I20140429000746 |
| Provider Name | Sarah C Deutsch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760624472 PECOS PAC ID: 0143446492 Enrollment ID: I20140723001439 |
| Provider Name | Timothy Maynard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942618657 PECOS PAC ID: 2466777966 Enrollment ID: I20150204000172 |
| Provider Name | Chriscia Bane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700416690 PECOS PAC ID: 5890126775 Enrollment ID: I20200508001055 |
| Provider Name | Star Michelle Roe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790393577 PECOS PAC ID: 5193088011 Enrollment ID: I20200916000292 |
| Provider Name | Jodi Lynn Silva-dutey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366084485 PECOS PAC ID: 1951733849 Enrollment ID: I20210413001464 |
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