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General NPI Number Information
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NPI Number | 1659627958
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Entity Type | Individual
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Provider Name | TEENA M. BRYSON MA, LPC, NCC, LSW
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Gender | Female
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Dates
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Enumeration Date | 07/24/2012
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Last Update Date | 07/24/2012
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Provider Practice Location Address
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Address Line | 1260 CENTRAL AVE
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City | BARBOURSVILLE
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State | WV
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Zip | 25504-2111
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Country | US
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Telephone | 304-617-5014
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Fax | 304-736-5111
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Provider Business Mailing Address
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Address Line | 1260 CENTRAL AVE
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City | BARBOURSVILLE
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State | WV
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Zip | 25504-2111
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Country | US
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Telephone | 304-617-5014
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Fax | 304-736-5111
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1470
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | S-0014449
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License Number State | OH
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