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Organization

PSIMED OASIS, LLC

Active
Other names
OASIS, LLC
Organization subpart
No

Provider details

NPI number
Authorized official
MS. FREDDIE V SIZEMORE (DIRECTOR OF FINANCE)
(304) 776-7606
Entity
Organization

Contact information

Practice address
100 PEYTON WAY, CHARLESTON, WV 25309-8572
(304) 720-8466
(304) 720-8463
Mailing address
PO BOX 7310, CHARLESTON, WV 25356-0310
(304) 776-7606
(304) 776-7636

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
103T00000X
Psychologist
Primary
1041C0700X
Clinical Social Worker

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4004010000
WV
Enumeration date
07/02/2006
Last updated
06/17/2008
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