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General NPI Number Information
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NPI Number | 1821549478
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Entity Type | Organization
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Legal Business Name | NICHOLAS COUNTY COMMUNITY CORRECTIONS
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Dates
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Enumeration Date | 10/19/2016
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Last Update Date | 10/19/2016
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Provider Practice Location Address
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Address Line | 603 BROAD ST
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City | SUMMERSVILLE
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State | WV
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Zip | 26651-1307
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Country | US
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Telephone | 304-872-9645
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Fax | 304-872-9643
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Provider Business Mailing Address
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Address Line | 603 BROAD ST
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City | SUMMERSVILLE
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State | WV
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Zip | 26651-1307
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Country | US
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Telephone | 304-872-9645
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Fax | 304-872-9643
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Authorized Official
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Title or Position | ASSISTANT PROGRAM DIRECTOR
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Name | MRS. STEPHANIE L WESTFALL
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Credential |
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Telephone | 304-872-9645
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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