NPIMap

Organization Active NPI

Harrison County Society for Crippled Children and Adults

Doing business as Childrens Treatment Ctr and Adult Therapy Clinic

  • Speech-Language Pathologist
  • Clarksburg, WV
National Provider Identifier
1912162082
Registry record updated Mar 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
HARRISON COUNTY SOCIETY FOR CRIPPLED CHILDREN AND ADULTS
Doing business as
Childrens Treatment Ctr and Adult Therapy Clinic
Practice address
171Liberty Ave
Clarksburg, WV 26301-0000
Phone
(304) 624-5009
Fax
(304) 624-5107
NPI assigned
Jul 28, 2008
Last updated
Mar 4, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2009

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

Authorized official

Name
Mrs. Lynda Joyce Menendez
Title
Executive Director
Phone
(304) 624-5009

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU
Speech-Language Pathologist 235Z00000X NU Primary

Addresses

Primary practice location

171Liberty Ave
Clarksburg, WV 26301-0000

Mailing address

171Liberty Ave
Clarksburg, WV 26301-0000
Phone (304) 624-5009

Other identifiers 1

IdentifierTypeStateIssuer
3810001801MedicaidWV

Other names 1

  • Childrens Treatment Ctr and Adult Therapy Clinic Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236124800000",
    "number": "1912162082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171LIBERTY AVE",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263010000",
            "telephone_number": "304-624-5009",
            "fax_number": "304-624-5107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171LIBERTY AVE",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263010000",
            "telephone_number": "304-624-5009",
            "fax_number": "304-624-5107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARRISON COUNTY SOCIETY FOR CRIPPLED CHILDREN AND ADULTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-28",
        "last_updated": "2009-03-04",
        "status": "A",
        "authorized_official_last_name": "MENENDEZ",
        "authorized_official_first_name": "LYNDA",
        "authorized_official_middle_name": "JOYCE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "304-624-5009",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810001801",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Childrens Treatment Ctr and Adult Therapy Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clarksburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.