Organization
FAMILY SERVICE DIV OF GOODWILL INDUSTRIES OF KYOWVA AREA, INC.
Active
Other names
Family Service
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALISSA STEWART (EXECUTIVE DIRECTOR)
(304) 523-9454
Entity
Organization
Contact information
Practice address
1102 MEMORIAL BLVD. W., HUNTINGTON, WV 25701
(304) 523-9545
(304) 525-7038
Mailing address
1102 MEMORIAL BLVD. W., HUNTINGTON, WV 25701
(304) 523-9545
(304) 525-7038
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
27907
WV
101YP2500X
Professional Counselor
1678
WV
101YP2500X
Professional Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1851371058
NPI GENERAL PRACTICE
WV
Enumeration date
05/03/2007
Last updated
12/22/2015
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