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General NPI Number Information
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NPI Number | 1215058987
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Entity Type | Organization
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Legal Business Name | CRIMSON COUNSELING SERVICES
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 443 W PIKE ST
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City | CLARKSBURG
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State | WV
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Zip | 26301-2711
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Country | US
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Telephone | 304-622-4786
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Fax | 304-622-7210
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Provider Business Mailing Address
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Address Line | PO BOX 1676
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City | CLARKSBURG
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State | WV
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Zip | 26302-1676
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Country | US
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Telephone | 304-622-4786
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Fax | 304-622-7210
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. PERRY LEE CAIN
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Credential | MA
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Telephone | 304-622-4786
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 071752
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License Number State | WV
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