Healthcare Provider Details

I. General information

NPI: 1053260836
Provider Name (Legal Business Name): BENJAMIN PAULEY MA
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2026
Last Update Date: 01/26/2026
Certification Date: 01/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

152 MISTY LN
PRINCETON WV
24740-6462
US

IV. Provider business mailing address

1301 LEBANON ST
BLUEFIELD WV
24701-4417
US

V. Phone/Fax

Practice location:
  • Phone: 304-223-5200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: