Provider Demographics
NPI: | 1811281611 |
---|---|
Name: | OHIO VALLEY COUNSELING SERVICES |
Entity type: | Organization |
Organization Name: | OHIO VALLEY COUNSELING SERVICES |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CLINICAL THERAPIST |
Authorized Official - Prefix: | MS |
Authorized Official - First Name: | JANE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | AMMONS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 304-218-0895 |
Mailing Address - Street 1: | 324 7TH & LAFAYETTE ST |
Mailing Address - Street 2: | |
Mailing Address - City: | MOUNDSVILLE |
Mailing Address - State: | WV |
Mailing Address - Zip Code: | 26041 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 304-218-0895 |
Mailing Address - Fax: | 740-968-7173 |
Practice Address - Street 1: | 54 INDIANA ST |
Practice Address - Street 2: | |
Practice Address - City: | WHEELING |
Practice Address - State: | WV |
Practice Address - Zip Code: | 26003-2280 |
Practice Address - Country: | US |
Practice Address - Phone: | 304-218-0895 |
Practice Address - Fax: | 740-968-7173 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2011-06-09 |
Last Update Date: | 2011-06-09 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
OH | C0700218 | 251S00000X |
WV | 2007 | 251S00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251S00000X | Agencies | Community/Behavioral Health |