MEDICARE: HEWLETT A TROGDON 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
1	101YP2500X	Professional Counselor	1592	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346578440
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEWLETT A TROGDON LPC

Provider Business Mailing Address
First Line	:	99 CRACKER BARREL DR STE 100
Second Line	:
City	:	BARBOURSVILLE
State	:	WV
Zip	:	25504-1650
Country	:	US
Telephone Number	:	304-525-7851
Fax Number	:

Provider Business Practice Location Address
First Line	:	203 KENOVA AVE
Second Line	:
City	:	WAYNE
State	:	WV
Zip	:	25570-9795
Country	:	US
Telephone Number	:	304-525-7851
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2009
Last Update Date	:	09/10/2024

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