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NPI Code Detail

MEDICARE: MRS. REGINA NORUM L.P.C.

MEDICARE: MRS. REGINA NORUM L.P.C.
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
1101YM0800XMental Health Counselor1072WV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1172882OTHERWVCOMPSYCH

General Provider Information

NPI Number : 1689714883
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. REGINA NORUM L.P.C.
Provider Business Mailing Address
First Line : 1005 QUINCY ST
Second Line :
City : PARKERSBURG
State : WV
Zip : 26101-4809
Country : US
Telephone Number : 304-485-8167
Fax Number : 304-485-8167
Provider Business Practice Location Address
First Line : 1005 QUINCY ST
Second Line :
City : PARKERSBURG
State : WV
Zip : 26101-4809
Country : US
Telephone Number : 304-485-8167
Fax Number : 304-485-8167
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2007
Last Update Date : 07/08/2007

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