Provider Demographics
NPI:1083428734
Name:CRITTENTON SERVICES
Entity type:Organization
Organization Name:CRITTENTON SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMMUNITY LIAISON
Authorized Official - Prefix:MS
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:KOCHER
Authorized Official - Suffix:
Authorized Official - Credentials:RBA
Authorized Official - Phone:304-455-3035
Mailing Address - Street 1:761 3RD ST
Mailing Address - Street 2:
Mailing Address - City:NEW MARTINSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26155-1403
Mailing Address - Country:US
Mailing Address - Phone:304-455-3035
Mailing Address - Fax:
Practice Address - Street 1:761 3RD ST # 1403
Practice Address - Street 2:
Practice Address - City:NEW MARTINSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26155-1403
Practice Address - Country:US
Practice Address - Phone:304-455-3035
Practice Address - Fax:304-455-3035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Single Specialty