LOGAN-MINGO AREA MENTAL HEALTH, INC
NPI 1205525276
Pharmacy in Logan, WV

Q: What is the provider's specialty?

The provider's specialty is Pharmacy with taxonomy code 333600000X.

Active since May 04, 2023CLIA 51D2104089 · Waiver

174 LMAH CENTER RD, LOGAN, WV 25601(304) 792-7130(304) 896-5184 Get Directions Write a Review

NPPES record last updated: March 11, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 11, 2026, May 18, 2023, May 4, 2023 (3 updates tracked since 2023).

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About Logan-mingo Area Mental Health, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LOGAN-MINGO AREA MENTAL HEALTH, INC (NPI 1205525276), doing business as Mountain Laurel Integrated Healthcare, is a healthcare organization registered as a pharmacy in Logan, West Virginia and active in the NPI registry since May 2023. The organization holds a CLIA Waiver certificate valid through October 26, 2027 and lists Angela L Robertson, Finance Director, as its authorized official.

NPPES Registry Identity

NPI1205525276

Entity TypeOrganization

Primary Taxonomy333600000X

Legal Business NameLOGAN-MINGO AREA MENTAL HEALTH, INC

Location Address174 LMAH CENTER RDLogan, WV 25601-4058

Mailing AddressPo Box 176Logan, WV 25601-0176 · (304) 792-7130 · Fax (304) 896-5184

Phone(304) 792-7130

Fax(304) 896-5184

Organization SubpartNo

Authorized OfficialAngela L RobertsonFinance Director · (304) 792-7130

Enumeration DateMay 4, 2023

Last NPPES UpdateMarch 11, 20263 updates tracked since enumeration

NPPES CertifiedMarch 11, 2026

✔ NPI 1205525276 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacySuppliers

Taxonomy Code333600000X

Definition

A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

174 LMAH CENTER RD, Logan, WV 25601

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Other Names 1

Doing Business AsMountain Laurel Integrated Healthcare

Other Identifiers 2

Other5059060Ncpdp

OtherSP0552603WV · Pharmacy License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 51D2104089

Logan Mingo Area Mental Health Inc · Logan, WV

Active · expires Oct 26, 2027

CLIA Number51D2104089

Laboratory TypeBehavioral Hlth Facility

Certificate Effective DateOctober 27, 2025

Certificate Expiration DateOctober 26, 2027

Laboratory DirectorDonna J. Cooke

Laboratory Phone(304) 792-7130

Laboratory LocationLogan Mingo Area Mental Health Inc174 Lmamh Center Road, Logan, WV 25601

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LOGAN-MINGO AREA MENTAL HEALTH, INC

Clinic/Center (Developmental Disabilities)