| Mental And Social Health Center | |
|
667 Huyett Rd Charles Town WV 25414-5378 | |
| (304) 725-4160 | |
| Not Available |
| Full Name | Mental And Social Health Center |
|---|---|
| Speciality | Social Worker |
| Location | 667 Huyett Rd, Charles Town, West Virginia |
| Authorized Official Name and Position | Michael Shor (MEMBER) |
| Authorized Official Contact | 3047254160 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mental And Social Health Center 44 Paddock Pl Charles Town WV 25414-5329 Ph: (304) 725-4160 | Mental And Social Health Center 667 Huyett Rd Charles Town WV 25414-5378 Ph: (304) 725-4160 |
| NPI Number | 1710391057 |
|---|---|
| Provider Enumeration Date | 06/15/2014 |
| Last Update Date | 06/15/2014 |
| Medicare PECOS PAC ID | 3274825427 |
|---|---|
| Medicare Enrollment ID | O20160707002184 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710391057 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | BP00944336 (West Virginia) | Primary |
| Provider Name | Elizabeth R Shor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730345182 PECOS PAC ID: 8729264437 Enrollment ID: I20110513000496 |
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