Provider Demographics
NPI:1467288878
Name:MUSICK, CARLA JEAN (PRSS)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:JEAN
Last Name:MUSICK
Suffix:
Gender:F
Credentials:PRSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 CRANE ST
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-8564
Mailing Address - Country:US
Mailing Address - Phone:304-560-9001
Mailing Address - Fax:
Practice Address - Street 1:240 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:OAK HILL
Practice Address - State:WV
Practice Address - Zip Code:25901-3006
Practice Address - Country:US
Practice Address - Phone:681-823-4257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)