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General NPI Number Information
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NPI Number | 1346381324
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Entity Type | Individual
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Provider Name | JOHN W. STREETER L.P.C., N.C.C., CAAT
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Gender | Male
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Dates
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Enumeration Date | 02/10/2007
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Last Update Date | 04/25/2010
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Provider Practice Location Address
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Address Line | 236 W MARTIN ST
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City | MARTINSBURG
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State | WV
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Zip | 25401-3331
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Country | US
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Telephone | 304-263-8522
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Fax | 304-263-8559
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Provider Business Mailing Address
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Address Line | PO BOX 672
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City | SHEPHERDSTOWN
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State | WV
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Zip | 25443-0672
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Country | US
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Telephone | 304-876-9258
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Fax | 304-876-9258
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 1568
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License Number State | WV
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