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Individual

LEONARD LEROY WELLMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.A,, C.A.C.

Contact information

Practice address
2121 EOFF ST, WHEELING, WV 26003-3805
(304) 234-3570
(304) 234-3511
Mailing address
RR 1 BOX 152A, GLEN EASTON, WV 26039-9730

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
WV
103T00000X
Psychologist
Primary
1003
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1003
BCBS
WV
Enumeration date
04/08/2011
Last updated
04/08/2011
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