Organization
PEACE VALLEY COUNSELING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPHINE MARIE HENSLEY LPC (LPC/OWNER)
(681) 313-7674
Entity
Organization
Contact information
Practice address
527 2ND AVE, SOUTH CHARLESTON, WV 25303-1310
(681) 341-2993
Mailing address
527 2ND AVE, SOUTH CHARLESTON, WV 25303-1310
(681) 341-2993
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
103TC0700X
Clinical Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1770136533
NPI
—
Enumeration date
05/29/2021
Last updated
05/29/2021
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