Individual
ARDITH PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
700 TECHNOLOGY DR, SOUTH CHARLESTON, WV 25309-8571
(304) 746-5300
(304) 746-3912
Mailing address
700 TECHNOLOGY DR, SOUTH CHARLESTON, WV 25309-8571
(304) 746-5300
(304) 746-3912
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
DP00944180
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005355002
—
WV
Enumeration date
03/19/2014
Last updated
03/20/2019
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