Wayne Matthew Bachelor

Individual provider Active NPI Peer Specialist · Huntington, WV

NPI 1154046514 · NPPES record last updated Oct 21, 2024

Key facts

NPI
1154046514
Entity type
Individual (NPI type 1)
Primary specialty
Peer Specialist 175T00000X
Practice address
1057 6TH Ave
Huntington, WV 25701-2307
Phone
(681) 378-6922
NPI assigned
Oct 7, 2022
Sex
Male
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-State Addiction Recovery Resources Current
since Oct 9, 2022
Accepting new patients

Locations

1057 6th Ave
Huntington, WV 25701
Phone (681) 372-6922

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X Yes

Addresses

Primary practice location

1057 6TH Ave
Huntington, WV 25701-2307

Mailing address

1057 6TH Ave
Huntington, WV 25701-2307
Phone (681) 378-6922

Other practice location 1

802 Oak St
Kenova, WV 25530-1519
Phone (304) 908-1056

Other providers in Huntington, WV

All providers in Huntington, WV · Peer Specialist in West Virginia

Sources for this page

Verify at the official NPI Registry.