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General NPI Number Information
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NPI Number | 1194002790
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Entity Type | Organization
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Legal Business Name | OHIO VALLEY COUNSELING SERVICE
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Dates
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Enumeration Date | 11/09/2011
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Last Update Date | 11/09/2011
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Provider Practice Location Address
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Address Line | 324 7TH ST
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City | MOUNDSVILLE
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State | WV
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Zip | 26041-2125
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Country | US
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Telephone | 304-843-0909
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Fax | 304-843-0999
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Provider Business Mailing Address
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Address Line | 324 7TH ST
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City | MOUNDSVILLE
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State | WV
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Zip | 26041-2125
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Country | US
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Telephone | 304-843-0909
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Fax | 304-843-0999
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Authorized Official
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Title or Position | OWNER
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Name | JANE AMONS
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Credential | LPC
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Telephone | 304-843-0909
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | E0003658
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License Number State | WV
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