Organization Name: | PRIMARY PSYCHOLOGICAL CARE PLLC |
NPI Number: | 1609921261 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | THOMAS C STEIN (CLINICAL DIRECTOR) |
Mailing Address: | 216 Maple Avenue Moorefield |
State: | WV US |
Postal Code: | 26836 |
Phone Number: | 3045306748 |
Fax Number: | |
NPI Enumeration Date: | 01/24/2007 |
NPI Last Update Date: | 06/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 234 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WV |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |