Provider Demographics
NPI:1598880387
Name:SLOAN, NANCY JEAN (MA,WVLPC,WVLCSW)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:JEAN
Last Name:SLOAN
Suffix:
Gender:F
Credentials:MA,WVLPC,WVLCSW
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 6632
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25362-0632
Mailing Address - Country:US
Mailing Address - Phone:304-342-1568
Mailing Address - Fax:
Practice Address - Street 1:600 SHREWSBURY ST
Practice Address - Street 2:ROOM 320
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-1230
Practice Address - Country:US
Practice Address - Phone:304-342-1568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVCP00451847104100000X
WV457101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV000047896OtherMOUNTAIN STATE BLUECROSS