1679464895 NPI number — SOMERSET MENTAL HEALTH AND WELLNESS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679464895 NPI number — SOMERSET MENTAL HEALTH AND WELLNESS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOMERSET MENTAL HEALTH AND WELLNESS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679464895
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/15/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
342 COLLEGE AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MT PLEASANT
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15666-1750
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-244-8961
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
109 E MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOMERSET
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15501-2024
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-244-8961
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/15/2025

Additional Information

Authorized Official

Authorized Official Last Name:
DOLAN
Authorized Official First Name:
ROXANNE
Authorized Official Middle Name:
RACHEL
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
724-244-8961

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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