Provider Demographics
NPI:1285085837
Name:MARSHALL UNIVERSITY H.E.L.P. PROGRAM
Entity type:Organization
Organization Name:MARSHALL UNIVERSITY H.E.L.P. PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS DIRECTOR/ASSISTANT DIRECTO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MISSI
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-696-5220
Mailing Address - Street 1:520 18TH ST
Mailing Address - Street 2:MYERS HALL
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25755-2195
Mailing Address - Country:US
Mailing Address - Phone:304-696-5220
Mailing Address - Fax:304-696-3231
Practice Address - Street 1:520 18TH ST
Practice Address - Street 2:MYERS HALL
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25755-2195
Practice Address - Country:US
Practice Address - Phone:304-696-5220
Practice Address - Fax:304-696-3231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-24
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV391103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty