Provider Demographics
NPI:1528554524
Name:DOUGHTY, NATALIE ANN (LPC)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:ANN
Last Name:DOUGHTY
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 1:936 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-4737
Mailing Address - Country:US
Mailing Address - Phone:304-422-7300
Mailing Address - Fax:304-428-3719
Practice Address - Street 1:936 MARKET ST
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-4737
Practice Address - Country:US
Practice Address - Phone:304-422-7300
Practice Address - Fax:304-428-3719
Is Sole Proprietor?:No
Enumeration Date:2018-07-03
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2124101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health