Provider Demographics
NPI:1497062806
Name:HUNDLEY, BRIGID MARY (LPC)
Entity Type:Individual
Prefix:
First Name:BRIGID
Middle Name:MARY
Last Name:HUNDLEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:WV
Mailing Address - Zip Code:24901-0002
Mailing Address - Country:US
Mailing Address - Phone:540-219-9137
Mailing Address - Fax:304-362-8033
Practice Address - Street 1:544 HARMONY CREEK DR
Practice Address - Street 2:
Practice Address - City:CLINTONVILLE
Practice Address - State:WV
Practice Address - Zip Code:24931-1101
Practice Address - Country:US
Practice Address - Phone:540-219-9137
Practice Address - Fax:304-362-8033
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-07
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
VA0701004770101YP2500X
WV1976101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1497062806Medicaid
VA1831470491Medicaid