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General NPI Number Information
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NPI Number | 1477394724
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Entity Type | Organization
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Legal Business Name | SUPERPSYCHED SOLUTIONS LLC
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 761 TALLMANSVILLE RD
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City | BUCKHANNON
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State | WV
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Zip | 26201-1610
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Country | US
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Telephone | 304-314-4803
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Fax | 304-501-1851
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Provider Business Mailing Address
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Address Line | 761 TALLMANSVILLE RD
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City | BUCKHANNON
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State | WV
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Zip | 26201-1610
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Country | US
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Telephone | 304-314-4803
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Fax | 304-501-1851
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Authorized Official
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Title or Position | OWNER/OPERATOR/PROVIDER
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Name | MR. ROBERT W KISER
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Credential | LPC
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Telephone | 304-314-4803
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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