Individual
KENNETH DOUGLAS STOREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
1021 QUARRIER ST, SUITE 414, CHARLESTON, WV 25301-2338
(304) 340-3676
(304) 340-3688
Mailing address
1021 QUARRIER ST, SUITE 414, CHARLESTON, WV 25301-2338
(304) 340-3676
(304) 340-3688
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
BP00944133
WV
104100000X
Social Worker
BP00944133
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0023815000
—
WV
Enumeration date
07/24/2013
Last updated
07/24/2013
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