Healthcare Provider Details

I. General information

NPI: 1598880387
Provider Name (Legal Business Name): NANCY JEAN SLOAN MA,WVLPC,WVLCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 11/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 SHREWSBURY ST ROOM 320
CHARLESTON WV
25301-1230
US

IV. Provider business mailing address

PO BOX 6632
CHARLESTON WV
25362-0632
US

V. Phone/Fax

Practice location:
  • Phone: 304-342-1568
  • Fax:
Mailing address:
  • Phone: 304-342-1568
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number457
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberCP00451847
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: