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General NPI Number Information
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NPI Number | 1467055392
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Entity Type | Organization
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Legal Business Name | PSYCHOTHERAPY ASSOCIATES, LLC
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Dates
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Enumeration Date | 11/21/2020
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Last Update Date | 10/12/2024
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Provider Practice Location Address
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Address Line | 808 B ST
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City | SAINT ALBANS
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State | WV
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Zip | 25177-2727
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Country | US
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Telephone | 734-250-1273
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Fax |
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Provider Business Mailing Address
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Address Line | 503 MOUNTAIN DR
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City | SAINT ALBANS
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State | WV
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Zip | 25177-8736
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Country | US
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Telephone | 734-250-1273
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR CLINICAL OPERATI
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Name | KIMBERLY HUGHES
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Credential | PSYCHOLOGIST WV872
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Telephone | 734-250-1273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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