Provider Demographics
NPI:1841832813
Name:MY SEPTEMBER LLC
Entity type:Organization
Organization Name:MY SEPTEMBER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:SHERII
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:304-550-5030
Mailing Address - Street 1:PO BOX 1105
Mailing Address - Street 2:
Mailing Address - City:DUNBAR
Mailing Address - State:WV
Mailing Address - Zip Code:25064-7105
Mailing Address - Country:US
Mailing Address - Phone:304-550-5030
Mailing Address - Fax:
Practice Address - Street 1:301 WASHINGTON ST W
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25302-2230
Practice Address - Country:US
Practice Address - Phone:304-343-0044
Practice Address - Fax:304-343-0045
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:1302035
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-10-11
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty