Provider Demographics
NPI:1952804791
Name:MOUNTAIN VIEW MENTAL HEALTH, LLC
Entity Type:Organization
Organization Name:MOUNTAIN VIEW MENTAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NURSE PRACTITONER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:SALERNO
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:865-245-0515
Mailing Address - Street 1:576 FOOTHILLS PLZ
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37801-2305
Mailing Address - Country:US
Mailing Address - Phone:865-245-0515
Mailing Address - Fax:
Practice Address - Street 1:4233 OLD NILES FERRY RD
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37801-0643
Practice Address - Country:US
Practice Address - Phone:865-245-0515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-16
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN23995363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty