Provider Demographics
NPI:1053081182
Name:WINDING WAY LLC
Entity Type:Organization
Organization Name:WINDING WAY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR / LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:B
Authorized Official - Last Name:STIRE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:304-692-1131
Mailing Address - Street 1:PO BOX 1330
Mailing Address - Street 2:
Mailing Address - City:DELLSLOW
Mailing Address - State:WV
Mailing Address - Zip Code:26531-1330
Mailing Address - Country:US
Mailing Address - Phone:304-692-1131
Mailing Address - Fax:
Practice Address - Street 1:49 PARK RIDGE DR
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-4032
Practice Address - Country:US
Practice Address - Phone:304-692-1131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty