Provider Demographics
NPI:1295869840
Name:PSYCHOLOGICAL CONSULTATION AND ASSESSMENT
Entity type:Organization
Organization Name:PSYCHOLOGICAL CONSULTATION AND ASSESSMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT PSYCHOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:WORKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:304-776-7230
Mailing Address - Street 1:202 GLASS DR
Mailing Address - Street 2:
Mailing Address - City:CROSS LANES
Mailing Address - State:WV
Mailing Address - Zip Code:25313-1319
Mailing Address - Country:US
Mailing Address - Phone:304-776-7230
Mailing Address - Fax:304-776-7247
Practice Address - Street 1:202 GLASS DR
Practice Address - Street 2:
Practice Address - City:CROSS LANES
Practice Address - State:WV
Practice Address - Zip Code:25313-1319
Practice Address - Country:US
Practice Address - Phone:304-776-7230
Practice Address - Fax:304-776-7247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty