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Contact Information

MOUNTAIN STATE PSYCHOLOGICAL SERVICES, PLLC
130 CENTER ST
KEYSER, WV26726-3520
 Phone: 304-788-1113
 Fax: 304-788-2777
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Intellectual & Developmental Disabilities

103TM1800X 62 Psychologist, Clinical
 

Counselor

101Y00000X
 

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for MOUNTAIN STATE PSYCHOLOGICAL SERVICES PLLC · (Female)

NPI # 1326117409
Status Active
Credentials
Entity Individual
Enumeration date 11/06/2006
Last updated 09/11/2025 - About 9 months ago
Sole proprietor 1 Not specified
Identifiers
  • WV Medicaid 3810006086
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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