Sandra Kay Maynard, PH.D,LPC, NCC
Individual provider Active NPI Mental Health Counselor · Omar, WV
NPI 1780042408 · NPPES record last updated Feb 9, 2016
Key facts
- NPI
- 1780042408
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 217 (WV)
- Practice address
- RR 2 Box 980
Omar, WV 25638-9707 - Phone
- (304) 785-7702
- NPI assigned
- Feb 9, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 217 | WV | MD | Podiatrist |
| 2214 | WV | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Renewed Hope Counseling PLLC | Current | Accepting new patients | |
| Renewed Hope Counseling Centers | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 217 | WV | Yes |
Addresses
Primary practice location
RR 2 Box 980
Omar, WV 25638-9707
Mailing address
RR 2 Box 980
Omar, WV 25638-9707
Phone (304) 785-7702
Other providers in Omar, WV
- Kimberly Evans
- Delsie Jean Grimmett
- Frances Louise Hager
- Deborah Michelle Hensley
- Kimberly Louise Hensley
- Geneva Noe
- Bessie Pelkey
- Brenda Pennington
- Renewed Hope Counseling Centers
- Tara Tyneal Robinson
All providers in Omar, WV · Mental Health Counselor 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 Feb 9, 2016. 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.