Active NPI
Beverly Jean Wyatt, MSW,LSW
- Social Worker
- Pineville, WV
National Provider Identifier
1124142989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- AP00939569
- Practice address
- RRT 10 Main Street
Pineville, WV 24874-0123 - Phone
- (304) 732-9132
- Fax
- (304) 732-6589
- NPI assigned
- Mar 19, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | AP00939569 | WV | Primary |
Addresses
Primary practice location
RRT 10 Main Street
Pineville, WV 24874-0123
Mailing address
RRT 10 Main Street
P.O. Box 123
Pineville, WV 24874-0123
Phone (304) 732-9132
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP00939569 | WV | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mari Sullivan Walker Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Counseling Psychologist
- Pineville, WV
- NPI 1619073343
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1124142989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "RRT 10 MAIN STREET",
"address_2": "P.O. BOX 123",
"city": "PINEVILLE",
"state": "WV",
"postal_code": "248740123",
"telephone_number": "304-732-9132",
"fax_number": "304-732-6589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "RRT 10 MAIN STREET",
"city": "PINEVILLE",
"state": "WV",
"postal_code": "248740123",
"telephone_number": "304-732-9132",
"fax_number": "304-732-6589"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYATT",
"first_name": "BEVERLY",
"middle_name": "JEAN",
"name_prefix": "Mrs.",
"credential": "MSW,LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-19",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "WV",
"license": "AP00939569",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pineville, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.