David Brandon Lawson
Individual provider Active NPI Clinical Psychologist · Pineville, WV
NPI 1134428469 · NPPES record last updated May 18, 2011
Key facts
- NPI
- 1134428469
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 1014 (WV)
- Practice address
- Rural RT. 10 438 River Road
Pineville, WV 24874-0274 - Phone
- (304) 732-0071
- Fax
- (304) 732-0070
- NPI assigned
- Mar 25, 2011
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110527000214 | WV | Practitioner - Psychologist Billing Independently | 3072790120 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1014 | WV | MD | Hearing Instrument Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lantern Mental Health Inc | Psychologist | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1014 | WV | |
| Adult Development & Aging Psychologist | 103TA0700X | 1014 | WV | |
| Cognitive & Behavioral Psychologist | 103TB0200X | 1014 | WV | |
| Clinical Psychologist | 103TC0700X | 1014 | WV | Yes |
| Counseling Psychologist | 103TC1900X | 1014 | WV | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 1014 | WV | |
| Family Psychologist | 103TF0000X | 1014 | WV | |
| Group Psychotherapy Psychologist | 103TP2701X | 1014 | WV |
Addresses
Primary practice location
Rural RT. 10 438 River Road
Pineville, WV 24874-0274
Mailing address
PO Box 274
Rural RT. 10 438 River Road
Pineville, WV 24874-0274
Phone (304) 732-0071
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3810019842 | Medicaid | WV |
Other providers in Pineville, WV
- Kevin Todd Kissel
- Destiny Lafferty
- Summer Lafferty
- Lantern Mental Health Inc
- Dominador Yti Lao
- Kara Lester
- Life Guard Inc
- Ashley Brooke Lilly-Queen
- Mari Sullivan Walker Inc
- Irene B Menego
All providers in Pineville, WV · Clinical Psychologist 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 May 18, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.