Organization
PROFESSIONAL COUNSELING ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN CAROL BAISDEN PHD (OWNER THERAPIST)
(304) 235-3390
Entity
Organization
Contact information
Practice address
41 W 5TH AVE, WILLIAMSON, WV 25661-3201
(304) 235-3390
(304) 235-3391
Mailing address
41 W 5TH AVE, WILLIAMSON, WV 25661-3201
(304) 235-3390
(304) 235-3391
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
538
WV
103T00000X
Psychologist
Primary
403
WV
1041C0700X
Clinical Social Worker
CP00452669
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0163475000
—
WV
01
—
062399
VALUE OPTIONS
—
05
—
3810007784
—
WV
Enumeration date
12/22/2006
Last updated
08/03/2015
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