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General NPI Number Information
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NPI Number | 1811852411
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Entity Type | Organization
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Legal Business Name | COMMUNITY CARE OF WEST VIRGINIA
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Dates
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Enumeration Date | 12/17/2025
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 100 MARKET PL
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City | BRIDGEPORT
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State | WV
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Zip | 26330-9168
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Country | US
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Telephone | 304-848-5770
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Fax |
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Provider Business Mailing Address
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Address Line | 100 MARKET PL
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City | BRIDGEPORT
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State | WV
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Zip | 26330-9168
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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 | UNLICENSED THERAPIST- SBBH
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Name | RAYNA ADAMY
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Credential |
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Telephone | 304-848-5770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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