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General NPI Number Information
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NPI Number | 1891736724
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Entity Type | Organization
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Legal Business Name | HUNTINGTON BEHAVIORAL HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 06/10/2006
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Last Update Date | 06/06/2008
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Provider Practice Location Address
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Address Line | 1623 13TH AVE
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City | HUNTINGTON
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State | WV
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Zip | 25701-3845
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Country | US
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Telephone | 304-526-2243
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Fax | 304-526-2220
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Provider Business Mailing Address
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Address Line | 3440 BLUE SULPHUR GDNS
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City | ONA
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State | WV
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Zip | 25545-9757
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Country | US
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Telephone | 304-733-2229
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Fax | 304-733-2229
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Authorized Official
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Title or Position | PRESIDENT
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Name | KENNETH J DEVLIN
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Credential | M.A.
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Telephone | 304-733-2229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 362
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License Number State | WV
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