Leslie B Gough
Individual provider Active NPI Case Manager/Care Coordinator · Chester, WV
NPI 1043812969 · NPPES record last updated Nov 16, 2020
Key facts
- NPI
- 1043812969
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 256 Alba Ave
Chester, WV 26034-1559 - Phone
- (304) 479-5144
- NPI assigned
- Nov 16, 2020
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Yes |
Addresses
Primary practice location
256 Alba Ave
Chester, WV 26034-1559
Mailing address
PO Box 434
Chester, WV 26034-0434
Phone (304) 479-5144
Other providers in Chester, WV
- Foxcrest, Inc.
- Amanda Fraser
- Jarrett Gittings
- Joseph Scott Gittings II
- Kelly Gittings
- Harvest Healthcare Solutions LLC
- Brandi Headley
- Robyn Huffman
- Ishimaru Medical Services LLC
- James Thomas Karnoupakis
All providers in Chester, WV · Case Manager/Care Coordinator in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.