Psychological Consultation and Assessment

Organization Active NPI Psychologist · Cross Lanes, WV

NPI 1295869840 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1295869840
Entity type
Organization (NPI type 2)
Primary specialty
Psychologist 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
Organization subpart
No

Authorized official

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

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WV

Medicare enrollment records

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

Locations

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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist
Group: 193400000X SINGLE SPECIALTY GROUP
103T00000X Yes

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

Other providers in Cross Lanes, WV

All providers in Cross Lanes, WV · Psychologist in West Virginia

Sources for this page

Verify at the official NPI Registry.