Provider Demographics
NPI:1558414300
Name:GEORGES, NANCY ANN (LPC CCAC LSW)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:ANN
Last Name:GEORGES
Suffix:
Gender:F
Credentials:LPC CCAC LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 12 STREET
Mailing Address - Street 2:SUITE 303
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003
Mailing Address - Country:US
Mailing Address - Phone:304-233-8045
Mailing Address - Fax:304-233-8085
Practice Address - Street 1:40 12 STREET
Practice Address - Street 2:SUITE 303
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003
Practice Address - Country:US
Practice Address - Phone:304-233-8045
Practice Address - Fax:304-233-8085
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV98-102101YA0400X
WVAP00940434104100000X
WV1279101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVY312145OtherHEALTH PLAN MANAGEMENT
WV98102OtherHORIZON BEHAVIORAL HEALTH
WVWVMX7070OtherADVANTAGE HEALTH
WVY312145OtherHEALTH PLAN OF THE UPPER
WV001712843OtherBS OF WV MOUNTAIN STATE