Healthcare Provider Details

I. General information

NPI: 1982339321
Provider Name (Legal Business Name): ALLISON DAWN SMITH-VARNEY MSW, LGSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2022
Last Update Date: 07/20/2022
Certification Date: 07/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6135 SISSONVILLE DR
CHARLESTON WV
25312-9444
US

IV. Provider business mailing address

104 ALEX LN
CHARLESTON WV
25304-2952
US

V. Phone/Fax

Practice location:
  • Phone: 304-984-1576
  • Fax: 304-984-1565
Mailing address:
  • Phone: 304-734-2040
  • Fax: 304-734-2047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberBP00946233
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: