Healthcare Provider Details

I. General information

NPI: 1972437556
Provider Name (Legal Business Name): VALLEY MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 HUMMINGBIRD LN
INDEPENDENCE WV
26374-8537
US

IV. Provider business mailing address

207 HUMMINGBIRD LN
INDEPENDENCE WV
26374-8537
US

V. Phone/Fax

Practice location:
  • Phone: 304-698-6819
  • Fax:
Mailing address:
  • Phone: 304-698-6819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: TAMMY PARKER
Title or Position: AMAP
Credential:
Phone: 304-698-6819