Healthcare Provider Details

I. General information

NPI: 1962554618
Provider Name (Legal Business Name): FAMILY & MARITAL COUNSELING CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 BROWN AVE
WESTON WV
26452-2177
US

IV. Provider business mailing address

5 BROWN AVE
WESTON WV
26452-2177
US

V. Phone/Fax

Practice location:
  • Phone: 304-269-3923
  • Fax: 304-269-9733
Mailing address:
  • Phone: 304-269-3923
  • Fax: 304-269-9733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number454
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number687
License Number StateWV
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number934
License Number StateWV
# 4
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberAP00941728
License Number StateWV

VIII. Authorized Official

Name: MR. DONALD E WORTH
Title or Position: OWNER
Credential: M.A.
Phone: 304-269-3923