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General NPI Number Information
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NPI Number | 1487354866
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Entity Type | Organization
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Legal Business Name | RUNNER COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 03/06/2023
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Last Update Date | 07/04/2023
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Provider Practice Location Address
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Address Line | 2413 E PIKE ST STE 125
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City | CLARKSBURG
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State | WV
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Zip | 26301-9117
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Country | US
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Telephone | 304-202-7001
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Fax | 808-640-3628
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Provider Business Mailing Address
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Address Line | 229 JOHNSON AVE # A
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City | BRIDGEPORT
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State | WV
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Zip | 26330-1608
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Country | US
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Telephone | 304-838-1122
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Fax | 808-640-3628
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | KELLEY RUNNER
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Credential |
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Telephone | 304-202-7001
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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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