Organization
PSYCHOLOGICAL ASSESSMENT AND INTERVENTION SERVICES, LLC
Active
Other names
Clarvida
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA MARIE WHITE (WV DIRECTOR OF OPERATIONS)
(304) 992-6153
Entity
Organization
Contact information
Practice address
1 DUNBAR PLZ STE 100A, DUNBAR, WV 25064-3038
(304) 346-9586
(304) 344-2169
Mailing address
10304 SPOTSYLVANIA AVE STE 300, FREDERICKSBURG, VA 22408-8605
(304) 346-9586
(304) 344-2169
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
566
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005412000
—
WV
05
—
0005412001
—
WV
05
—
0005412003
—
WV
01
—
001710371
MT STATE BCBS
WV
05
—
0163911000
—
WV
01
—
490712
AETNA VALUE OPTIONS
WV
01
—
70365
UMWA
WV
Enumeration date
03/14/2007
Last updated
07/10/2024
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