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General NPI Number Information
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NPI Number | 1912913773
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Entity Type | Organization
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Legal Business Name | SPAULDING PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 12/06/2024
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Provider Practice Location Address
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Address Line | 1809 DUPONT RD STE 3
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City | PARKERSBURG
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State | WV
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Zip | 26101-9704
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Country | US
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Telephone | 304-861-5184
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Fax | 304-861-5187
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Provider Business Mailing Address
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Address Line | 123 CANTERBURY DR
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City | PARKERSBURG
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State | WV
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Zip | 26104-8057
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Country | US
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Telephone | 304-861-5184
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Fax | 304-861-5187
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Authorized Official
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Title or Position | OWNER
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Name | CYNTHIA D SPAULDING
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Credential | M.A.
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Telephone | 304-861-5184
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 017787
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License Number State | WV
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