Individual
CELISE'CC' R ROXBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSS, BSP
Contact information
Practice address
445 MAIN ST, BENWOOD, WV 26031-1105
(304) 559-3199
Mailing address
PO BOX 7, BENWOOD, WV 26031-0007
(304) 559-3199
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103K00000X
Behavior Analyst
—
—
104100000X
Social Worker
Primary
—
WV
106E00000X
Assistant Behavior Analyst
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8120209
—
WV
Enumeration date
02/08/2023
Last updated
01/15/2024
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