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General NPI Number Information
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NPI Number | 1366370090
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Entity Type | Organization
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Legal Business Name | SOUTHERN HIGHLANDS
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Dates
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Enumeration Date | 05/12/2026
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Last Update Date | 05/12/2026
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Provider Practice Location Address
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Address Line | 200 12TH STREET EXT
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City | PRINCETON
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State | WV
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Zip | 24740-2398
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Country | US
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Telephone | 304-425-9541
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Fax |
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Provider Business Mailing Address
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Address Line | 413 WILEY ST
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City | PRINCETON
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State | WV
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Zip | 24740-3432
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Country | US
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Telephone | 304-972-7362
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | ANDREA RENAE WASHINGTON
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Credential | MSW
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Telephone | 304-425-9541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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