Organization · Type 2 NPI
Mountain Laurel Psychiatry LLC
Psychiatric/Mental Health Nurse Practitioner · Bridgeport, WV
NPI number
1861340432
Active
Practice location
2000 Jerry Dove Dr Ste 102
Bridgeport, WV 26330-9166
Fax (304) 449-5899
Mailing address
205 S Virginia Ave Unit 27
Bridgeport, WV 26330-5004
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | None listed |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
3 other providers at this address
About NPI 1861340432
Mountain Laurel Psychiatry LLC's National Provider Identifier is 1861340432, issued on Mar 19, 2026. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Bridgeport, WV. The record was last updated on Sep 4, 2026.