Healthcare Provider Details

I. General information

NPI: 1528812591
Provider Name (Legal Business Name): RONALENE HOLT DELLIGATTI MSW, LGSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2024
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 PROFESSIONAL PL STE 101
BRIDGEPORT WV
26330-4599
US

IV. Provider business mailing address

2000 COOMBS FARM RD
MORGANTOWN WV
26508-0053
US

V. Phone/Fax

Practice location:
  • Phone: 304-513-3495
  • Fax:
Mailing address:
  • Phone: 304-381-2211
  • Fax: 304-206-3121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberBP00944011
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: