Healthcare Provider Details
I. General information
NPI: 1194894170
Provider Name (Legal Business Name): BEHAVIORAL SCIENCE ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/06/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
53 14TH ST SUITE 805
WHEELING WV
26003-3433
US
IV. Provider business mailing address
RR 2 BOX 238
TRIADELPHIA WV
26059-9610
US
V. Phone/Fax
- Phone: 304-232-7295
- Fax: 304-232-7296
- Phone: 304-336-9963
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 241 |
| License Number State | WV |
VIII. Authorized Official
Name: DR.
BARBARA
L
RUSH
Title or Position: PSYCHOLOGIST
Credential: PH.D.
Phone: 304-336-9963