Provider Demographics
NPI:1194759092
Name:POSTON, CAROLYN SUE (PT)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:SUE
Last Name:POSTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:SUE
Other - Last Name:SIBRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:400 COURT ST STE 100
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25301-1652
Mailing Address - Country:US
Mailing Address - Phone:304-347-6120
Mailing Address - Fax:304-347-6142
Practice Address - Street 1:400 COURT ST STE 100
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-1652
Practice Address - Country:US
Practice Address - Phone:304-347-6120
Practice Address - Fax:304-347-6142
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1712225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVCF9824OtherRR MEDICARE
WVP00173998OtherRR MEDICARE
WV2154793OtherUHC
WV0158054000Medicaid
151628500OtherFEDERAL WORKERS' COMP
WV0867594OtherDME - CIGNA
WV1063634OtherWORKERS COMP
WV0011253000Medicaid
001720268OtherMOUNTAIN STATE BCBS
WV2154793OtherUHC
001720268OtherMOUNTAIN STATE BCBS
WV0158054000Medicaid
WV9296571Medicare PIN
WVP00173998OtherRR MEDICARE
WV2154793OtherUHC
WV0158054000Medicaid