Healthcare Provider Details

I. General information

NPI: 1437502358
Provider Name (Legal Business Name): RICHARD EDWARD CORWIN LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2016
Last Update Date: 07/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 13TH STREET
HUNTINGTON WV
25701-1712
US

IV. Provider business mailing address

220 13TH STREET
HUNTINGTON WV
25701-1712
US

V. Phone/Fax

Practice location:
  • Phone: 304-525-9355
  • Fax: 304-522-0835
Mailing address:
  • Phone: 304-525-9355
  • Fax: 304-522-0835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: