Provider Demographics
NPI:1962546622
Name:PYRAMID COUNSELING LIMITED LIABILITY COMPANY
Entity type:Organization
Organization Name:PYRAMID COUNSELING LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:DWAYNE
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:MASTERS
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:304-256-0200
Mailing Address - Street 1:130 GEORGE ST # 6
Mailing Address - Street 2:SUITE E - F
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-2648
Mailing Address - Country:US
Mailing Address - Phone:304-256-0200
Mailing Address - Fax:304-256-0380
Practice Address - Street 1:130 GEORGE ST # 6
Practice Address - Street 2:SUITE E - F
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-2648
Practice Address - Country:US
Practice Address - Phone:304-256-0200
Practice Address - Fax:304-256-0380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1622101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV=========OtherTAX ID#