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General NPI Number Information
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NPI Number | 1245753250
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Entity Type | Organization
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Legal Business Name | MOUNTAIN CAP OF WEST VIRGINIA INC.
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Dates
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Enumeration Date | 07/21/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 26 N KANAWHA ST STE 201
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City | BUCKHANNON
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State | WV
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Zip | 26201-2714
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Country | US
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Telephone | 304-472-1500
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Fax | 304-472-9064
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Provider Business Mailing Address
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Address Line | 26 N KANAWHA ST STE 201
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City | BUCKHANNON
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State | WV
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Zip | 26201-2714
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Country | US
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Telephone | 304-472-1500
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Fax | 304-472-9064
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | KATHY MCMURRAY
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Credential |
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Telephone | 304-472-1500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | DP00945017
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License Number State | WV
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