Provider Demographics
NPI:1477394724
Name:SUPERPSYCHED SOLUTIONS LLC
Entity type:Organization
Organization Name:SUPERPSYCHED SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR/PROVIDER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:KISER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:304-460-4870
Mailing Address - Street 1:761 TALLMANSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BUCKHANNON
Mailing Address - State:WV
Mailing Address - Zip Code:26201-1610
Mailing Address - Country:US
Mailing Address - Phone:304-460-4870
Mailing Address - Fax:
Practice Address - Street 1:761 TALLMANSVILLE RD
Practice Address - Street 2:
Practice Address - City:BUCKHANNON
Practice Address - State:WV
Practice Address - Zip Code:26201-1610
Practice Address - Country:US
Practice Address - Phone:304-460-4870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-03
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty