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General NPI Number Information
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NPI Number | 1073681755
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Entity Type | Organization
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Legal Business Name | ALLEGHENY COUNSELING SERVICES
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 06/20/2012
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Provider Practice Location Address
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Address Line | 300 FOXCROFT AV STE 306
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City | MARTINSBURG
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State | WV
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Zip | 25401
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Country | US
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Telephone | 304-267-1663
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Fax | 304-267-1663
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Provider Business Mailing Address
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Address Line | PO BOX 2712
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City | MARTINSBURG
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State | WV
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Zip | 25402
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Country | US
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Telephone | 304-267-1663
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Fax | 304-267-1663
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST OWNER
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Name | DR. BRUCE P JENNINGS
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Credential | PHD
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Telephone | 304-267-1663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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