Healthcare Provider Details

I. General information

NPI: 1962772897
Provider Name (Legal Business Name): PRESTERA CENTER FOR MENTAL HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2012
Last Update Date: 05/14/2024
Certification Date: 05/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3375 US ROUTE 60 E
HUNTINGTON WV
25705-2837
US

IV. Provider business mailing address

5600 US ROUTE 60
HUNTINGTON WV
25705-2146
US

V. Phone/Fax

Practice location:
  • Phone: 304-525-7851
  • Fax: 304-525-1504
Mailing address:
  • Phone: 304-525-7851
  • Fax: 304-525-1073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number016
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number016
License Number StateWV

VIII. Authorized Official

Name: LISA IRENE ZAPPIA
Title or Position: PRESIDENT/CEO
Credential: MBA, MA, NCC, LPC
Phone: 304-399-7760