1245986082 NPI number — RONNI BETH VANCE M.ED , NCC,LPC #2578

Table of content: RONNI BETH VANCE M.ED , NCC,LPC #2578 (NPI 1245986082)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245986082 NPI number — RONNI BETH VANCE M.ED , NCC,LPC #2578

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VANCE
Provider First Name:
RONNI
Provider Middle Name:
BETH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.ED , NCC,LPC #2578
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
VANCE
Provider Other First Name:
RONNI
Provider Other Middle Name:
BETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RONNI VANCE M.ED,NCC
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1245986082
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/01/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 307
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VERDUNVILLE
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
25649-0307
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-784-4059
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
101 DINGESS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOGAN
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25601-3603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-688-9269
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/01/2022

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  2578 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com