Provider Demographics
NPI:1215743703
Name:HUMPHREY, JAMIE ELIZABETH (PSYD)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:ELIZABETH
Last Name:HUMPHREY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1448 10TH AVENUE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-3579
Mailing Address - Country:US
Mailing Address - Phone:304-691-6381
Mailing Address - Fax:304-691-8591
Practice Address - Street 1:1115 20TH STREET
Practice Address - Street 2:SUITE 205
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25703-2071
Practice Address - Country:US
Practice Address - Phone:304-939-6487
Practice Address - Fax:304-523-4358
Is Sole Proprietor?:No
Enumeration Date:2024-12-09
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV1369103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist