# PEACE VALLEY COUNSELING CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548836653
- **Authorized official:** JOSEPHINE MARIE HENSLEY LPC (LPC/OWNER)
- **Authorized official phone:** (681) 313-7674

## Contact information

- **Practice address:** 527 2ND AVE, SOUTH CHARLESTON, WV 25303-1310
- **Practice address phone:** (681) 341-2993
- **Mailing address:** 527 2ND AVE, SOUTH CHARLESTON, WV 25303-1310
- **Mailing address phone:** (681) 341-2993

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 101YP2500X | Professional Counselor | — | NULL | Yes |
| 101YP2500X | Professional Counselor | — | — | Yes |
| 103TC0700X | Clinical Psychologist | — | NULL | — |
| 103TC0700X | Clinical Psychologist | — | — | — |
| 103TC1900X | Counseling Psychologist | — | NULL | — |
| 103TC1900X | Counseling Psychologist | — | — | — |

## Other

- **Enumeration date:** 05/29/2021
- **Last updated:** 05/29/2021