| Intercessory Counseling And Consulting Outreach Inc | |
|
1113b Jefferson Rd S Charleston WV 25309-9780 | |
| (304) 415-5715 | |
| Not Available |
| Full Name | Intercessory Counseling And Consulting Outreach Inc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1113b Jefferson Rd, S Charleston, West Virginia |
| Authorized Official Name and Position | Derrick Gibson (PROVIDER) |
| Authorized Official Contact | 3044155715 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Intercessory Counseling And Consulting Outreach Inc 1113b Jefferson Rd S Charleston WV 25309-9780 Ph: (304) 415-5715 | Intercessory Counseling And Consulting Outreach Inc 1113b Jefferson Rd S Charleston WV 25309-9780 Ph: (304) 415-5715 |
| NPI Number | 1508473141 |
|---|---|
| Provider Enumeration Date | 09/28/2020 |
| Last Update Date | 09/28/2020 |
| Certification Date | 09/28/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508473141 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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