Healthcare Provider Details

I. General information

NPI: 1902701238
Provider Name (Legal Business Name): KATHY GAY SALVUCCI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1012 KANAWHA BLVD E
CHARLESTON WV
25301-2840
US

IV. Provider business mailing address

1012 KANAWHA BLVD E
CHARLESTON WV
25301-2840
US

V. Phone/Fax

Practice location:
  • Phone: 304-347-9818
  • Fax: 304-347-9820
Mailing address:
  • Phone: 304-347-9818
  • Fax: 304-347-9820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberAP00139154
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: