Individual
GLENNIS E PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
97 GREAT TEAYS BLVD STE 6, SCOTT DEPOT, WV 25560
(304) 757-6999
(304) 757-3252
Mailing address
97 GREAT TEAYS BLVD STE 6, SCOTT DEPOT, WV 25560-9816
(304) 757-6999
(304) 201-5019
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
1691
WV
101YA0400X
Addiction (Substance Use Disorder) Counselor
218606
WV
101YP2500X
Professional Counselor
Primary
1691
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1691
LPC
WV
05
—
1952426736
—
WV
01
—
218606
NBCC
WV
Enumeration date
03/20/2007
Last updated
06/17/2020
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