Harris, Teddy A
Harris, Teddy A is an individual health care provider with primary practice located at 99 Tavern Rd , Martinsburg WV 25401-2890. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Harris, Teddy A can be contacted via phone (304) 263-7023.Contact Information
Primary practice address
99 Tavern Rd
Martinsburg WV 25401-2890
Phone: (304) 263-7023
Fax: (304) 264-0508
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | CP00939221 | West Virginia |
Profile Details
| NPI number | 1588663256 |
|---|---|
| LBN Legal business name | Harris, Teddy A |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 15th, 2005 |
| Last updated | Jan 14th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588663256 | NPPES |
| West Virginia | MEDICAID | 3810000510 |
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