Organization Active NPI

Nancy Rabel Canterbury, M.a., Inc.

  • Clinical Psychologist
  • Charleston, WV
National Provider Identifier
1902049828
Registry record updated Apr 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
275 Issued in WV
Legal business name
NANCY RABEL CANTERBURY, M.A., INC.
Practice address
3100 Maccorkle Ave SE
Suite 401
Charleston, WV 25304-1223
Phone
(304) 346-6161
Fax
(304) 346-6166
NPI assigned
Apr 7, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2009

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

Authorized official

Name
Nancy Canterbury
Title
Pres.
Phone
(304) 346-6161

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 275 WV Primary

Addresses

Primary practice location

3100 Maccorkle Ave SE
Suite 401
Charleston, WV 25304-1223

Mailing address

3100 Maccorkle Ave SE
Suite 401
Charleston, WV 25304-1223
Phone (304) 346-6161

Other identifiers 1

IdentifierTypeStateIssuer
0165269000MedicaidWV

National Provider Directory

National Provider Directory

Locations

3100 Maccorkle Ave SE
Ste 401
Charleston, WV 25304
Phone (304) 346-6161

NPI Registry JSON

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

{
    "created_epoch": "1239062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239062400000",
    "number": "1902049828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 MACCORKLE AVE SE",
            "address_2": "SUITE 401",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041223",
            "telephone_number": "304-346-6161",
            "fax_number": "304-346-6166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 MACCORKLE AVE SE",
            "address_2": "SUITE 401",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041223",
            "telephone_number": "304-346-6161",
            "fax_number": "304-346-6166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NANCY RABEL CANTERBURY, M.A., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-07",
        "last_updated": "2009-04-07",
        "status": "A",
        "authorized_official_last_name": "CANTERBURY",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "PRES.",
        "authorized_official_telephone_number": "304-346-6161"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "WV",
            "license": "275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0165269000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2009; 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.