1285647982 NPI number — AREA PSYCHIATRIC & PSYCHOTHERAPY GRP INC

Table of content: (NPI 1285647982)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285647982 NPI number — AREA PSYCHIATRIC & PSYCHOTHERAPY GRP INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AREA PSYCHIATRIC & PSYCHOTHERAPY GRP INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285647982
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/22/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10 W 6TH AVE
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
HUNTINGTON
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
25701
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-525-9355
Provider Business Mailing Address Fax Number:
304-522-0835

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 W 6TH AVE
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
HUNTINGTON
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-525-9355
Provider Business Practice Location Address Fax Number:
304-522-0835
Provider Enumeration Date:
08/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WEBB
Authorized Official First Name:
DELENO
Authorized Official Middle Name:
H
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
304-525-9355

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2084P2900X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 0011951000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0116666000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".




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