Mrs Wanda Mae Dettinger, LPC LSW is a
Social Worker based in Charleston, West Virginia. Mrs Wanda Mae Dettinger is licensed to practice in West Virginia (license number AP00938675) and her current practice location is
1418 A Maccorkle Ave Sw, Charleston, West Virginia. She can be reached at her office (for appointments etc.) via phone at
(304) 348-1288.
NPI number for Mrs Wanda Mae Dettinger is 1639196124 and her current mailing address is Po Box 4009, Charleston, West Virginia. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1639196124.
Healthcare Provider's Profile
| Full Name | Mrs Wanda Mae Dettinger |
|---|
| Gender | Female |
|---|
| Speciality | Social Worker |
|---|
| Location | 1418 A Maccorkle Ave Sw, Charleston, West Virginia |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1639196124
- Provider Enumeration Date: 07/17/2006
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Mrs Wanda Mae Dettinger such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1639196124 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YP2500X | Counselor - Professional | 1564 (West Virginia) | Primary |
| 104100000X | Social Worker | AP00938675 (West Virginia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Wanda Mae Dettinger is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mrs Wanda Mae Dettinger, LPC LSW
Po Box 4009,
Charleston, WV 25364-4009
Ph: (304) 348-1288 | Mrs Wanda Mae Dettinger, LPC LSW
1418 A Maccorkle Ave Sw,
Charleston, WV 25303
Ph: (304) 348-1288 |
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