Individual provider Active NPI

Hewlett A Trogdon, LPC

  • Professional Counselor
  • Wayne, WV
National Provider Identifier
1346578440
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1592 Issued in WV
Practice address
203 Kenova Ave
Wayne, WV 25570-9795
Phone
(304) 525-7851
NPI assigned
Dec 1, 2009
Last updated
Sep 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1592 WV Primary

Addresses

Primary practice location

203 Kenova Ave
Wayne, WV 25570-9795

Mailing address

99 Cracker Barrel Dr Ste 100
Barboursville, WV 25504-1650
Phone (304) 525-7851

Other identifiers 1

IdentifierTypeStateIssuer
0005355002MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240109003141 WV Practitioner - Mental Health Counselor 9638520125 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3375 US Route 60
Huntington, WV 25705-2837
Phone (304) 525-7851

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1592WVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prestera Center for Mental Health Services Inc CurrentSince Jan 1, 2024 Accepting new patients
Prestera Center for Mental Health Services Inc CurrentSince Jan 1, 2024 Accepting new patients
Prestera Center for Mental Health Services Inc Past Accepting new patients
Prestera Center for Mental Health Services, Inc Past Accepting new patients

Locations

99 Cracker Barrel Dr
Ste 100
Barboursville, WV 25504
Phone 30452578512514

25 Lincoln Plz
Branchland, WV 25506
Phone (304) 525-7854

511 Morris St
Ste 306
Charleston, WV 25301

376 Kenmore Dr
Danville, WV 25053
Phone (304) 369-1930

625 8th St
Huntington, WV 25701
Phone (681) 208-4535

710 Viand St
Point Pleasant, WV 25550
Phone 3045257851 ext. 3520

712 Main St
Pt Pleasant, WV 25550

203 Kenova Ave
Wayne, WV 25570
Phone (304) 272-5136

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1259625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1346578440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 CRACKER BARREL DR STE 100",
            "city": "BARBOURSVILLE",
            "state": "WV",
            "postal_code": "255041650",
            "telephone_number": "304-525-7851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 KENOVA AVE",
            "city": "WAYNE",
            "state": "WV",
            "postal_code": "255709795",
            "telephone_number": "304-525-7851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROGDON",
        "first_name": "HEWLETT",
        "middle_name": "A",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-01",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WV",
            "license": "1592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005355002",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, WV

Sources for this page

Verify at the official NPI Registry.