Organization
COUNSELING AND WELLNESS CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRISCILLA F LEAVITT PHD (CLINICAL DIRECTOR)
(304) 422-7300
Entity
Organization
Contact information
Practice address
936 MARKET ST, PARKERSBURG, WV 26101
(304) 422-7300
(304) 428-3719
Mailing address
936 MARKET ST, PARKERSBURG, WV 26101
(304) 422-7300
(304) 428-3719
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810000414
—
WV
01
—
9346391
MEDICARE RAILROAD
WV
Enumeration date
04/21/2006
Last updated
05/09/2013
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