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NPI Code Detail

MEDICARE: LEAH MCINTIRE, MA, LPC

MEDICARE: LEAH MCINTIRE, MA, LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency2014WV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11588090385OTHERWVNPI

General Provider Information

NPI Number : 1063832707
Entity Type Code : Organization
Provider Name (Legal Business Name) : LEAH MCINTIRE, MA, LPC
Provider Business Mailing Address
First Line : 5000 GREENBAG RD
Second Line : SUITE M4
City : MORGANTOWN
State : WV
Zip : 26501-7163
Country : US
Telephone Number : 304-241-4123
Fax Number : 304-381-4447
Provider Business Practice Location Address
First Line : 5000 GREENBAG RD
Second Line : SUITE M4
City : MORGANTOWN
State : WV
Zip : 26501-7163
Country : US
Telephone Number : 304-241-4123
Fax Number : 304-381-4447
Authorized Official
Title or Position : LICENSED COUNSELOR
Name : MRS. LEAH K MCINTIRE
Credential : MA, LPC
Telephone Number : 304-241-4123
Provider Enumeration Date : 04/21/2014
Last Update Date : 04/21/2014

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