| Southern Psychiatric Services | |
|
414 Greenway Ave Suite 200 Charleston WV 25309-1426 | |
| (304) 414-9161 | |
| Not Available |
| Full Name | Southern Psychiatric Services |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 414 Greenway Ave, Charleston, West Virginia |
| Authorized Official Name and Position | Randy L Warren (OWNER) |
| Authorized Official Contact | 3044149161 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Psychiatric Services 414 Greenway Ave Suite 200 Charleston WV 25309-1426 Ph: (304) 414-9161 | Southern Psychiatric Services 414 Greenway Ave Suite 200 Charleston WV 25309-1426 Ph: (304) 414-9161 |
| NPI Number | 1578639878 |
|---|---|
| Provider Enumeration Date | 11/28/2006 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578639878 | NPI | - | NPPES |
| 3810003269 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (West Virginia) | Primary |
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