MEDICARE: OHIO VALLEY COUNSELING SERVICES

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	251S00000X	Community/Behavioral Health Agency	C0700218	OH
2	251S00000X	Community/Behavioral Health Agency	2007	WV

General Provider Information

NPI Number	:	1811281611
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OHIO VALLEY COUNSELING SERVICES

Provider Business Mailing Address
First Line	:	324 7TH & LAFAYETTE ST
Second Line	:
City	:	MOUNDSVILLE
State	:	WV
Zip	:	26041
Country	:	US
Telephone Number	:	304-218-0895
Fax Number	:	740-968-7173

Provider Business Practice Location Address
First Line	:	54 INDIANA ST
Second Line	:
City	:	WHEELING
State	:	WV
Zip	:	26003-2280
Country	:	US
Telephone Number	:	304-218-0895
Fax Number	:	740-968-7173

Authorized Official
Title or Position	:	CLINICAL THERAPIST
Name	:	MS. JANE AMMONS
Credential	:
Telephone Number	:	304-218-0895

Provider Enumeration Date	:	06/09/2011
Last Update Date	:	06/09/2011

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Directions to “OHIO VALLEY COUNSELING SERVICES ” Practice Location

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