Healthcare Provider Details

I. General information

NPI: 1790674752
Provider Name (Legal Business Name): ANNE H GREZA LGSW, PMH-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNE L HARMAN

II. Dates (important events)

Enumeration Date: 07/02/2025
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CORPORATE DR
MORGANTOWN WV
26501-4580
US

IV. Provider business mailing address

100 CORPORATE DR
MORGANTOWN WV
26501-4580
US

V. Phone/Fax

Practice location:
  • Phone: 304-241-1766
  • Fax: 304-381-2648
Mailing address:
  • Phone: 304-241-1766
  • Fax: 304-381-2648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberBP00945322
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: