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General NPI Number Information
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NPI Number | 1831198662
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Entity Type | Individual
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Provider Name | FANNIE ELAINE LOUGHRIDGE MA LPC ADC
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Gender | Female
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Dates
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Enumeration Date | 07/14/2005
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Last Update Date | 04/01/2020
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Provider Practice Location Address
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Address Line | 642 BRADY ST
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City | BARBOURSVILLE
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State | WV
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Zip | 25504-1340
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Country | US
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Telephone | 304-733-1833
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Fax | 304-733-4833
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Provider Business Mailing Address
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Address Line | PO BOX 283
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City | BARBOURSVILLE
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State | WV
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Zip | 25504-0283
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Country | US
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Telephone | 304-733-1833
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Fax | 304-733-4833
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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 | 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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