Provider Demographics
NPI:1982206017
Name:APPALACHIAN THERAPY SERVICES LLC
Entity Type:Organization
Organization Name:APPALACHIAN THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHLEE
Authorized Official - Middle Name:
Authorized Official - Last Name:CALANDROS-KELLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, LPC, ALPS
Authorized Official - Phone:304-792-0244
Mailing Address - Street 1:955 MATHEWS AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25302-2722
Mailing Address - Country:US
Mailing Address - Phone:304-792-0244
Mailing Address - Fax:
Practice Address - Street 1:955 MATHEWS AVE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25302-2722
Practice Address - Country:US
Practice Address - Phone:304-792-0244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty