NPIMap

Organization Active NPI

Raleigh County Commission on Aging, Inc.

  • Counseling Psychologist
  • Beckley, WV
National Provider Identifier
1376809186
Registry record updated Apr 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Legal business name
RALEIGH COUNTY COMMISSION ON AGING, INC.
Practice address
1614 S Kanawha St
Beckley, WV 25801-6239
Phone
(304) 255-1397
Fax
(304) 252-9360
NPI assigned
Apr 5, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2012

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

Authorized official

Name
Mr. Jack Tanner
Title
Executive Director
Phone
(304) 255-1397

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC1900X WV Primary
Attendant Care ProviderGroup: 193200000X MULTI-SPECIALTY GROUP 3747A0650X WV

Addresses

Primary practice location

1614 S Kanawha St
Beckley, WV 25801-6239

Mailing address

1614 S Kanawha St
Beckley, WV 25801-6239
Phone (304) 255-1397

Other identifiers 2

IdentifierTypeStateIssuer
1619185147MedicaidWV
3810022491MedicaidWV

National Provider Directory

National Provider Directory
Tax ID family
Raleigh County Commission on Aging Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1333584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333584000000",
    "number": "1376809186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1614 S KANAWHA ST",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258016239",
            "telephone_number": "304-255-1397",
            "fax_number": "304-252-9360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1614 S KANAWHA ST",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258016239",
            "telephone_number": "304-255-1397",
            "fax_number": "304-252-9360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALEIGH COUNTY COMMISSION ON AGING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-05",
        "last_updated": "2012-04-05",
        "status": "A",
        "authorized_official_last_name": "TANNER",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "304-255-1397",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": "WV",
            "license": null,
            "primary": true
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Attendant Care Provider",
            "state": "WV",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619185147",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810022491",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beckley, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.