MEDICARE: DENISE NOEL AMMONS MA, LSW, LPC, CCAC

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	101YM0800X	Mental Health Counselor	1777	WV

General Provider Information

NPI Number	:	1962569491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENISE NOEL AMMONS MA, LSW, LPC, CCAC

Provider Business Mailing 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

Provider Business Practice Location Address
First Line	:	120 PROFESSIONAL PL STE 101
Second Line	:
City	:	BRIDGEPORT
State	:	WV
Zip	:	26330-4599
Country	:	US
Telephone Number	:	304-513-3495
Fax Number	:	800-734-8498

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

Provider Enumeration Date	:	01/03/2007
Last Update Date	:	04/07/2026

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