Healthcare Provider Details
I. General information
NPI: 1255064135
Provider Name (Legal Business Name): PURSUECARE WEST VIRGINIA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/07/2022
Last Update Date: 07/18/2023
Certification Date: 07/18/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1400 SARATOGA AVE OFC 101
MORGANTOWN WV
26505-3116
US
IV. Provider business mailing address
101 CENTERPOINT DR STE 105
MIDDLETOWN CT
06457-7568
US
V. Phone/Fax
- Phone: 860-322-6712
- Fax: 860-469-2766
- Phone: 860-317-5251
- Fax: 860-469-2766
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC1900X |
| Taxonomy | Counseling Psychologist |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | |
| License Number State | |
| # 12 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LA2200X |
| Taxonomy | Adult Health Nurse Practitioner |
| License Number | |
| License Number State | |
| # 13 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
| # 14 | |
| Primary Taxonomy | N |
| Taxonomy Code | 364SA2100X |
| Taxonomy | Acute Care Clinical Nurse Specialist |
| License Number | |
| License Number State | |
| # 15 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2083A0300X |
| Taxonomy | Addiction Medicine (Preventive Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JAMES
ULAGER
Title or Position: MD
Credential: MD
Phone: 860-215-2295