Provider Demographics
NPI:1821458928
Name:WV INSTITUTE FOR SPIRITULIATY
Entity Type:Organization
Organization Name:WV INSTITUTE FOR SPIRITULIATY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:412-901-4259
Mailing Address - Street 1:1601 VIRGINIA ST E
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25311-2113
Mailing Address - Country:US
Mailing Address - Phone:304-345-0926
Mailing Address - Fax:304-345-8206
Practice Address - Street 1:1601 VIRGINIA ST E
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25311-2113
Practice Address - Country:US
Practice Address - Phone:304-345-0926
Practice Address - Fax:304-345-8206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-02
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1228251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health