| Oasis, LLC | |
|
100 Peyton Way Charleston WV 25309-8572 | |
| (304) 720-8466 | |
| (304) 720-8463 |
| Full Name | Oasis, LLC |
|---|---|
| Speciality | Psychologist |
| Location | 100 Peyton Way, Charleston, West Virginia |
| Authorized Official Name and Position | Freddie V Sizemore (DIRECTOR OF FINANCE) |
| Authorized Official Contact | 3047767606 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oasis, LLC Po Box 7310 Charleston WV 25356-0310 Ph: (304) 776-7606 | Oasis, LLC 100 Peyton Way Charleston WV 25309-8572 Ph: (304) 720-8466 |
| NPI Number | 1013946920 |
|---|---|
| Provider Enumeration Date | 07/02/2006 |
| Last Update Date | 06/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013946920 | NPI | - | NPPES |
| 4004010000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (NU) | Secondary |
| 103T00000X | Psychologist | (NU) | Primary |
| 1041C0700X | Social Worker - Clinical | (NU) | Secondary |
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