Elise Ann Drake, PHD

Individual provider Active NPI Psychologist · Charleston, WV

NPI 1821344276 · NPPES record last updated Aug 2, 2012

Key facts

NPI
1821344276
Entity type
Individual (NPI type 1)
Primary specialty
Psychologist 103T00000X
License
1045 (WV)
Practice address
501 Morris St
Charleston, WV 25301-1326
Phone
(304) 388-9969
NPI assigned
Aug 2, 2012
Sex
Female
Sole proprietor
No

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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1045 WV Yes

Addresses

Primary practice location

501 Morris St
Charleston, WV 25301-1326

Mailing address

501 Morris St
Charleston, WV 25301-1326
Phone (304) 388-9969

Other providers in Charleston, WV

All providers in Charleston, WV · Psychologist in West Virginia

Sources for this page

Verify at the official NPI Registry.