Healthcare Provider Details

I. General information

NPI: 1376581942
Provider Name (Legal Business Name): CENTER FOR HEALTH PSYCHOLOGY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 11/16/2025
Certification Date: 11/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

179 SUMMERS ST
CHARLESTON WV
25301-2163
US

IV. Provider business mailing address

179 SUMMERS ST STE 710
CHARLESTON WV
25301-2122
US

V. Phone/Fax

Practice location:
  • Phone: 304-342-8300
  • Fax: 304-342-8311
Mailing address:
  • Phone: 304-342-8300
  • Fax: 304-342-8311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number514
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number514
License Number StateWV
# 3
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number514
License Number StateWV
# 4
Primary TaxonomyY
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number514
License Number StateWV

VIII. Authorized Official

Name: C DAVID BLAIR
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 304-342-8300