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General NPI Number Information
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NPI Number | 1942563903
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Entity Type | Individual
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Provider Name | ENOBONG J. INYANG LPC, LSOTP
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Gender | Male
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Dates
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Enumeration Date | 06/24/2012
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Last Update Date | 06/24/2012
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Provider Practice Location Address
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Address Line | 100 ANGUS E PEYTON DR
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City | CHARLESTON
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State | WV
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Zip | 25303-1600
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Country | US
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Telephone | 304-745-1951
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Fax | 304-746-1942
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Provider Business Mailing Address
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Address Line | PO BOX 20075
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City | CHARLESTON
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State | WV
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Zip | 25362-1075
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Country | US
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Telephone | 180-064-2984
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Fax | 304-746-1942
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 2042
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 61815
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2042
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License Number State | WV
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 61815
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 2042
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License Number State | WV
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Taxonomy #6
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 61815
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License Number State | TX
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