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160 Undercliff Ter Princeton WV 24740-2174 | |
| (304) 425-6110 | |
| (304) 487-6199 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 160 Undercliff Ter, Princeton, West Virginia |
| Authorized Official Name and Position | Twyla Hersman (LPC) |
| Authorized Official Contact | 3044256110 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
160 Undercliff Ter Princeton WV 24740-2174 Ph: (304) 425-6110 | 160 Undercliff Ter Princeton WV 24740-2174 Ph: (304) 425-6110 |
| NPI Number | 1972713121 |
|---|---|
| Provider Enumeration Date | 05/23/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972713121 | NPI | - | NPPES |
| 029884 | Other | VALUE OPTIONS | |
| 248572 | Other | ANTHEM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 136 (West Virginia) | Primary |
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