Provider Demographics
NPI:1093314825
Name:PASSAGES THERAPY AND COUNSELING, PLLC
Entity Type:Organization
Organization Name:PASSAGES THERAPY AND COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARLENA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHESTNUT
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:304-704-3885
Mailing Address - Street 1:PO BOX 290
Mailing Address - Street 2:
Mailing Address - City:HARMAN
Mailing Address - State:WV
Mailing Address - Zip Code:26270-0290
Mailing Address - Country:US
Mailing Address - Phone:304-704-3885
Mailing Address - Fax:
Practice Address - Street 1:200 WEESE ST
Practice Address - Street 2:
Practice Address - City:ELKINS
Practice Address - State:WV
Practice Address - Zip Code:26241-3758
Practice Address - Country:US
Practice Address - Phone:304-704-3885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-22
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty