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NPI Code Detail

MEDICARE: REBECCA MARIE WARNICK L.G.S.W

MEDICARE: REBECCA MARIE WARNICK L.G.S.W
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
1104100000XSocial WorkerBP00944794WV
21041C0700XClinical Social WorkerDP00944794WV

General Provider Information

NPI Number : 1720444854
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA MARIE WARNICK L.G.S.W
Provider Business Mailing Address
First Line : 65 PROFESSIONAL PL STE 102103
Second Line :
City : BRIDGEPORT
State : WV
Zip : 26330-0258
Country : US
Telephone Number : 304-848-5770
Fax Number : 304-848-0890
Provider Business Practice Location Address
First Line : 1005 WHITE WILLOW WAY
Second Line :
City : MORGANTOWN
State : WV
Zip : 26505-6119
Country : US
Telephone Number : 304-513-3495
Fax Number : 800-734-8498
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2016
Last Update Date : 04/10/2025

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