Organization
NEW MARTINSVILLE COUNSELING CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LYA BURGESS MSW, ACSW, LICSW (OWNER/ THERAPIST)
(304) 455-6505
Entity
Organization
Contact information
Practice address
525 THIRD ST., NEW MARTINSVILLE, WV 26155
(304) 455-6505
Mailing address
296 N STATE ROUTE 2 # 120, NEW MARTINSVILLE, WV 26155-2241
(304) 455-6505
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
DP00939169
WV
Other
Enumeration date
08/06/2007
Last updated
08/06/2007
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