Organization Name: | NEW MARTINSVILLE COUNSELING CENTER INC. |
NPI Number: | 1083805055 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LYA BURGESS (OWNER/ THERAPIST) |
Mailing Address: | 525 Third St. New Martinsville |
State: | WV US |
Postal Code: | 26155 |
Phone Number: | 3044556505 |
Fax Number: | |
NPI Enumeration Date: | 08/06/2007 |
NPI Last Update Date: | 08/06/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | DP00939169 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |