Organization Active NPI

Psychological Consultation and Assessment

  • Psychologist
  • Cross Lanes, WV
National Provider Identifier
1295869840
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
PSYCHOLOGICAL CONSULTATION AND ASSESSMENT
Practice address
202 Glass Dr
Cross Lanes, WV 25313-1319
Phone
(304) 776-7230
Fax
(304) 776-7247
NPI assigned
Mar 15, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Richard Workman, MANPI 1093711251
Title
Owner President Psychologist
Phone
(304) 776-7230

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

202 Glass Dr
Cross Lanes, WV 25313-1319

Mailing address

202 Glass Dr
Cross Lanes, WV 25313-1319
Phone (304) 776-7230

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250423000962 WV Part B Supplier - Clinic/Group Practice 5496270316 Receives reassigned benefits from 1 practitioner
Practice locations: Cross Lanes, WV

National Provider Directory

National Provider Directory

Locations

202 Glass Dr
Cross Lanes, WV 25313
Phone (304) 776-7230

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295869840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 GLASS DR",
            "city": "CROSS LANES",
            "state": "WV",
            "postal_code": "253131319",
            "telephone_number": "304-776-7230",
            "fax_number": "304-776-7247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 GLASS DR",
            "city": "CROSS LANES",
            "state": "WV",
            "postal_code": "253131319",
            "telephone_number": "304-776-7230",
            "fax_number": "304-776-7247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL CONSULTATION AND ASSESSMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WORKMAN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER PRESIDENT PSYCHOLOGIST",
        "authorized_official_telephone_number": "304-776-7230",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cross Lanes, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.