Healthcare Provider Details

I. General information

NPI: 1922626126
Provider Name (Legal Business Name): LUKE BADLEY LGSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2020
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 E 3RD AVE
RANSON WV
25438-1640
US

IV. Provider business mailing address

2500 FOUNDATION WAY
MARTINSBURG WV
25401-9000
US

V. Phone/Fax

Practice location:
  • Phone: 304-535-6343
  • Fax:
Mailing address:
  • Phone: 304-264-9202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1396
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberBP00945617
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: