Provider Demographics
NPI:1073754339
Name:FREMOUW SIGLEY & BAKER PSYCHOLOGICAL ASSOCIATES PLLC
Entity Type:Organization
Organization Name:FREMOUW SIGLEY & BAKER PSYCHOLOGICAL ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:HEMMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-598-2300
Mailing Address - Street 1:1445 STEWARTSTOWN RD STE 200
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-3868
Mailing Address - Country:US
Mailing Address - Phone:304-598-2300
Mailing Address - Fax:304-598-2307
Practice Address - Street 1:1445 STEWARTSTOWN RD STE 200
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-3868
Practice Address - Country:US
Practice Address - Phone:304-598-2300
Practice Address - Fax:304-598-2307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-17
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV002092959OtherBLUE CROSS BLUE SHIELD
WV3810014533Medicaid