MARI SULLIVAN WALKER INC — NPI 1619073343 (Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Counseling in PINEVILLE, WV)

CMS-1500 Box 24J / 33a • NPI

1619073343

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

103TC1900X (CMS 62)

Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Counseling

Box 32 Service Location & ZIP+4

RT#10 MAIN STREET, PINEVILLE, WV, 24874-0123

✓ 9-Digit EDI 837 ZIP+4 (24874-0123)

Practice Phone & Referral Fax

(304) 732-9132

Fax: (304) 732-6589

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1619073343 (MARI SULLIVAN WALKER INC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1619073343` (NPI-2 Organization / Facility)
Provider / Legal Name	MARI SULLIVAN WALKER INC
Plain-English Specialty	Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Counseling NUCC Code: `103TC1900X` (Psychologist, Counseling)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	RT#10 MAIN STREET, PINEVILLE, WV, 24874-0123
Practice Telephone / Fax	Tel: (304) 732-9132 \| Fax: (304) 732-6589
Administrative Mailing Address	RT#10 MAIN STREET P.O. BOX 123, PINEVILLE, WV, 24874-0123
Enumeration & Last Sync	Enumerated: 2006-09-16 \| CMS Record Updated: 2025-09-11
Authorized Official	MARI WALKER (CEO)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

RT#10 MAIN STREET, PINEVILLE, WV, 24874-0123

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Plain-English Taxonomy & CMS Crosswalk (103TC1900X)

What Does Taxonomy Code 103TC1900X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 103TC1900X translates to:
"Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Counseling"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 62 (Psychologist, Clinical)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Psychologist, Counseling for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (MARI SULLIVAN WALKER INC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`103T00000X` — Psychologist Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist	State: WV \| License: `203` \| Primary: Secondary
`103TB0200X` — Psychologist, Cognitive & Behavioral Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Cognitive & Behavioral	State: WV \| License: `203` \| Primary: Secondary
`103TC1900X` — Psychologist, Counseling Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Counseling	State: WV \| License: `203` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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MARI SULLIVAN WALKER INC (NPI #1619073343)