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502 Johnstown Rd Beckley WV 25801-4818 | |
| (304) 952-1193 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 502 Johnstown Rd, Beckley, West Virginia |
| Authorized Official Name and Position | Lawrence Jimmie Richmond (OWNER) |
| Authorized Official Contact | 3049521193 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
502 Johnstown Rd Beckley WV 25801-4818 Ph: (304) 952-1193 | 502 Johnstown Rd Beckley WV 25801-4818 Ph: (304) 952-1193 |
| NPI Number | 1962722538 |
|---|---|
| Provider Enumeration Date | 06/07/2010 |
| Last Update Date | 06/07/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962722538 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 965 (West Virginia) | Primary |
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