MEDITELECARE OF WEST VIRGINIA PLLC

CHARLESTON, WV
NPI1235631888
Entity TypeOrganization
Authorized ContactANDREA GODFREY
Credentialing & Enrollment Manager
860-788-6404
Organization Subpart ?No
Primary Taxonomy103TC0700X Psychologist, Clinical
Additional Taxonomies1041C0700X Social Worker, Clinical
2084P0800X Psychiatry & Neurology, Psychiatry
2084P0805X Psychiatry & Neurology, Geriatric Psychiatry
363L00000X Nurse Practitioner
363LP0808X Nurse Practitioner, Psych/Mental Health
Enumeration Date2018-02-28
Last Update Date2024-09-04
Business Address
MEDITELECARE OF WEST VIRGINIA PLLC
5400 BIG TYLER RD # D
CHARLESTON, WV 25313-1178
Phone number: 860-788-6404
Mailing Address
MEDITELECARE OF WEST VIRGINIA PLLC
PO BOX 1595
MIDDLETOWN, CT 06457-8095
Phone number: 860-788-6404