Healthcare Provider Details

I. General information

NPI: 1144575572
Provider Name (Legal Business Name): AUGUSTA LEVY LEARNING CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2012
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 ANTHONI AVE STE 300
WHEELING WV
26003-6403
US

IV. Provider business mailing address

PO BOX 6711
WHEELING WV
26003-0914
US

V. Phone/Fax

Practice location:
  • Phone: 304-242-6722
  • Fax: 304-242-6822
Mailing address:
  • Phone: 304-242-6722
  • Fax: 304-242-6822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: JESSICA OSMIANSKI
Title or Position: COO
Credential:
Phone: 304-242-6722