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NPI Code Detail

MEDICARE: MR. BRYAN E HENCHEY MS

MEDICARE: MR. BRYAN E HENCHEY MS
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 Counselor

General Provider Information

NPI Number : 1689782211
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRYAN E HENCHEY MS
Provider Business Mailing Address
First Line : HC 84 BOX 130
Second Line :
City : LAHMANSVILLE
State : WV
Zip : 26731-9700
Country : US
Telephone Number : 304-749-8862
Fax Number :
Provider Business Practice Location Address
First Line : 130 CENTER ST
Second Line : MOUNTAIN STATE PSYCHOLOGICAL SERVICES, PLLC
City : KEYSER
State : WV
Zip : 26726-3520
Country : US
Telephone Number : 304-788-1113
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2006
Last Update Date : 07/08/2007

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