Organization
UNITED SUMMIT CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA PRICE (AUTHORIZED OFFICIAL)
(304) 623-5661
Entity
Organization
Contact information
Practice address
6 HOSPITAL PLZ, CLARKSBURG, WV 26301-9316
(304) 623-5661
(304) 623-2989
Mailing address
6 HOSPITAL PLZ, CLARKSBURG, WV 26301-9316
(304) 598-6280
(304) 623-2989
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
20
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005239000
—
WV
05
—
0005239001
—
WV
05
—
0005239002
—
WV
01
—
0017100654
BLUE CROSS BLUE SHIELD
WV
01
—
001710655
BLUE CROSS BLUE SHIELD
WV
01
—
0018101987
BLUE CROSS BLUE SHIELD
WV
Enumeration date
05/15/2006
Last updated
06/23/2021
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