Healthcare Provider Details

I. General information

NPI: 1205751609
Provider Name (Legal Business Name): SUMMER A. BIVINS COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 VINE ST
BECKLEY WV
25801-4846
US

IV. Provider business mailing address

324 VINE ST
BECKLEY WV
25801-4846
US

V. Phone/Fax

Practice location:
  • Phone: 304-860-8317
  • Fax:
Mailing address:
  • Phone: 304-860-8317
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: SUMMER A. BIVINS
Title or Position: OWNER
Credential: MSW, LICSW
Phone: 304-860-8317