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General NPI Number Information
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NPI Number | 1396755302
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Entity Type | Organization
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Legal Business Name | PATHWAYS PSYCHOLOGICAL CENTER
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 07/14/2010
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Provider Practice Location Address
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Address Line | 207 SOUTH ST
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City | BLUEFIELD
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State | WV
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Zip | 24701
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Country | US
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Telephone | 304-327-5744
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Fax | 304-327-5746
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Provider Business Mailing Address
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Address Line | PO BOX 1504
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City | BLUEFIELD
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State | WV
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Zip | 24701-1504
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Country | US
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Telephone | 304-327-5744
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Fax | 304-327-5746
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Authorized Official
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Title or Position | PARTNER/LIC PSYCHOLOGIST
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Name | MR. STEVE FERRIS
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Credential | PSYCHOLOGIST
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Telephone | 304-327-5744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 430
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License Number State | WV
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