Thomas Odell Duvall, PHD, LMHC, NCC
Individual provider Active NPI Clinical Psychologist · Glenville, WV
NPI 1437145331 · NPPES record last updated Mar 13, 2018
Key facts
- NPI
- 1437145331
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PY9866 (FL)
- Practice address
- 201 Fci LN
Glenville, WV 26351-9500 - Phone
- (304) 626-2500
- Fax
- (304) 626-2604
- NPI assigned
- Sep 26, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH8470 | FL | MD | Mental Health Counselor |
| LPC005142 | GA | MD | Professional Counselor |
| PY9866 | FL | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fci Gilmer | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC005142 | GA | |
| Mental Health Counselor | 101YM0800X | MH8470 | FL | |
| Clinical Psychologist | 103TC0700X | PY9866 | FL | Yes |
Addresses
Primary practice location
201 Fci LN
Glenville, WV 26351-9500
Mailing address
PO Box 5000
Glenville, WV 26351-5000
Phone (304) 626-2500
Other providers in Glenville, WV
- Kimberly Dickey
- Destiny Marie Dobbins
- Margaret Dooley
- Heather Durham
- Brittany Duskey
- Fci Gilmer
- Kimberly Fleming
- Malinda Lucky Flores
- Abigail Fraley
- Brittanyann Fraley
All providers in Glenville, WV · Clinical Psychologist in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 13, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.