Provider Demographics
NPI:1972989994
Name:APPALACHIA COUNSELING & FAMILY SERVICES
Entity type:Organization
Organization Name:APPALACHIA COUNSELING & FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SINGLE MEMBER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NETA
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:MAYNARD
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:304-236-3517
Mailing Address - Street 1:105 W 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSON
Mailing Address - State:WV
Mailing Address - Zip Code:25661-3111
Mailing Address - Country:US
Mailing Address - Phone:304-236-3517
Mailing Address - Fax:
Practice Address - Street 1:105 W 4TH AVE
Practice Address - Street 2:
Practice Address - City:WILLIAMSON
Practice Address - State:WV
Practice Address - Zip Code:25661-3111
Practice Address - Country:US
Practice Address - Phone:304-236-3517
Practice Address - Fax:304-236-3518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-31
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVDP009437101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty