Organization
FAMILY PSYCHIATRIC SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK N CASDORPH MD (OWNER/DOCTOR)
(304) 343-5554
Entity
Organization
Contact information
Practice address
1573 WASHINGTON ST E, CHARLESTON, WV 25311-2505
(304) 343-5554
(304) 343-8492
Mailing address
1573 WASHINGTON ST E, CHARLESTON, WV 25311-2505
(304) 343-5554
(304) 343-8492
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
754
WV
103T00000X
Psychologist
766
WV
104100000X
Social Worker
350
WV
104100000X
Social Worker
761
WV
2084P0800X
Psychiatry Physician
Primary
1322
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810005459
—
WV
Enumeration date
10/27/2006
Last updated
06/15/2012
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