Laurel Mountain | |
502 Johnstown Rd Beckley WV 25801-4818 | |
(304) 952-1193 | |
Not Available |
Full Name | Laurel Mountain |
---|---|
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 |
---|---|
Laurel Mountain 502 Johnstown Rd Beckley WV 25801-4818 Ph: (304) 952-1193 | Laurel Mountain 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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