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General NPI Number Information
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NPI Number | 1710352232
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Entity Type | Organization
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Legal Business Name | STANLEY PSYCHOLOGICAL SERVICES, PLLC
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Dates
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Enumeration Date | 12/09/2015
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Last Update Date | 12/09/2015
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Provider Practice Location Address
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Address Line | 651 COLLIERS WAY SUITE 412
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City | WEIRTON
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State | WV
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Zip | 26062-5053
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Country | US
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Telephone | 304-559-3821
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Fax | 304-723-3426
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Provider Business Mailing Address
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Address Line | 651 COLLIERS WAY SUITE 412
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City | WEIRTON
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State | WV
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Zip | 26062-5053
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. PERRY GLENN STANLEY
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Credential |
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Telephone | 304-559-3821
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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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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