Provider Demographics
NPI:1568907319
Name:WHOLE BRAIN SOLUTIONS, LLC
Entity Type:Organization
Organization Name:WHOLE BRAIN SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND NEURO-PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:LAUREL
Authorized Official - Last Name:THORNTON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, NCC, ALPS
Authorized Official - Phone:681-285-1133
Mailing Address - Street 1:235 HIGH ST
Mailing Address - Street 2:SUITE 606
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-5429
Mailing Address - Country:US
Mailing Address - Phone:681-285-1133
Mailing Address - Fax:877-471-0537
Practice Address - Street 1:235 HIGH ST
Practice Address - Street 2:SUITE 606
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-5429
Practice Address - Country:US
Practice Address - Phone:681-285-1133
Practice Address - Fax:877-471-0537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-04
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2107251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health