| Neuropsychology Group Of West Virginia, Pllc | |
|
9000 Coombs Farm Drive Suite 202 Morgantown WV 26508 | |
| (304) 554-0504 | |
| (304) 554-0505 |
| Full Name | Neuropsychology Group Of West Virginia, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 9000 Coombs Farm Drive, Morgantown, West Virginia |
| Authorized Official Name and Position | Marissa E Carey (PARTNER) |
| Authorized Official Contact | 3045540504 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neuropsychology Group Of West Virginia, Pllc 9000 Coombs Farm Drive Suite 202 Morgantown WV 26508 Ph: (304) 554-0504 | Neuropsychology Group Of West Virginia, Pllc 9000 Coombs Farm Drive Suite 202 Morgantown WV 26508 Ph: (304) 554-0504 |
| NPI Number | 1396124160 |
|---|---|
| Provider Enumeration Date | 05/26/2015 |
| Last Update Date | 11/23/2015 |
| Medicare PECOS PAC ID | 0042526212 |
|---|---|
| Medicare Enrollment ID | O20150902001957 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396124160 | NPI | - | NPPES |
| 3910007046 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Secondary |
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Christina Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194798157 PECOS PAC ID: 1951333095 Enrollment ID: I20050909000049 |
| Provider Name | Marissa E Carey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861466187 PECOS PAC ID: 2062445760 Enrollment ID: I20050914000013 |
| Provider Name | Martin L Boone |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1538139902 PECOS PAC ID: 0749329498 Enrollment ID: I20091209000406 |
| Provider Name | Jason Alexander Chong |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1386923480 PECOS PAC ID: 2163695628 Enrollment ID: I20140204000133 |
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