Provider Demographics
NPI:1386125482
Name:OPOKU-ACHEAMPONG, OPHELIA
Entity type:Individual
Prefix:
First Name:OPHELIA
Middle Name:
Last Name:OPOKU-ACHEAMPONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:OPHELIA
Other - Middle Name:AMA ASANTEWAA
Other - Last Name:ADDAI BOATENG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:40 HIGH ST # 913
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-0172
Mailing Address - Country:US
Mailing Address - Phone:540-746-1830
Mailing Address - Fax:
Practice Address - Street 1:112 WEDGEWOOD DR APT 9
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-2480
Practice Address - Country:US
Practice Address - Phone:540-746-1830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-27
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVDP009448881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical