Healthcare Provider Details

I. General information

NPI: 1841525730
Provider Name (Legal Business Name): PREFERRED PSYCHOLOGICAL SOLUTIONS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2009
Last Update Date: 08/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1116 SMITH ST SUITE 207
CHARLESTON WV
25301-1314
US

IV. Provider business mailing address

1116 SMITH ST SUITE 207
CHARLESTON WV
25301-1314
US

V. Phone/Fax

Practice location:
  • Phone: 888-505-1862
  • Fax: 681-265-9250
Mailing address:
  • Phone: 888-505-1862
  • Fax: 681-265-9250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number936
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number936
License Number StateWV
# 3
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number936
License Number StateWV
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number936
License Number StateWV

VIII. Authorized Official

Name: MR. SCOTT A. SPAULDING
Title or Position: OWNER/PSYCHOLOGIST
Credential: MA
Phone: 888-505-1862