Provider Demographics
NPI:1063645885
Name:LEADING WAY CHRISTIAN COUNSELING SERVICE
Entity Type:Organization
Organization Name:LEADING WAY CHRISTIAN COUNSELING SERVICE
Other - Org Name:LEADING LADIES SUPPORT & COUNSELING CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR, LICENSED MINISTER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MAYOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-864-3055
Mailing Address - Street 1:PO BOX 777
Mailing Address - Street 2:
Mailing Address - City:REEDSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26547-0777
Mailing Address - Country:US
Mailing Address - Phone:304-864-3055
Mailing Address - Fax:304-864-3055
Practice Address - Street 1:12302 VETERANS MEMORIAL HWY
Practice Address - Street 2:VALLEY PROFESSIONAL PLAZA, SUITE 1
Practice Address - City:REEDSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26547
Practice Address - Country:US
Practice Address - Phone:304-864-3055
Practice Address - Fax:304-864-3055
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LEADING LADIES SUPPORT & COUNSELING CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-08-27
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health