Provider Demographics
NPI:1942712674
Name:FLANNERY, BEN RICHARD (MED)
Entity Type:Individual
Prefix:
First Name:BEN
Middle Name:RICHARD
Last Name:FLANNERY
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 5TH AVE STE 250
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-2238
Mailing Address - Country:US
Mailing Address - Phone:304-733-0036
Mailing Address - Fax:304-736-4835
Practice Address - Street 1:1000 5TH AVE STE 250
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-2238
Practice Address - Country:US
Practice Address - Phone:304-733-0036
Practice Address - Fax:304-736-4835
Is Sole Proprietor?:No
Enumeration Date:2017-11-03
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional