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Ravenlou Wamsley
Peer Specialist in Logan, West Virginia
NPI 1134845373

Ravenlou Wamsley is a Peer Specialist based in Logan, WV. Ravenlou Wamsley practices in Logan, WV. The NPI Number for Ravenlou Wamsley is 1134845373 and holds a License No. 22-9154 (West Virginia).

The current practice location address for Ravenlou Wamsley is 174 Lmah Center Rd, Logan, WV and can be reached out via phone at 304-792-7130 and via fax at 304-896-5184.

Location: 174 Lmah Center Rd, Logan, WV, 25601-0176
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1134845373
Provider Name
Ravenlou Wamsley
Credential
Provider Entity Type
Individual
Gender
Female
Address
174 Lmah Center Rd, Logan, WV, 25601-0176
Phone Number
304-792-7130
Fax Number
304-896-5184
Provider Enumeration Date
10/19/2022
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
22-9154 01 WV WV CERTIFICATION BOARD FOR ADDICTION AND PREVENTION PROFESSIONALS
institution
Provider Business Practice Location Address Details
Address
174 Lmah Center Rd
City
Logan
State
West Virginia
Zip
25601-4058
Phone Number
304-792-7130
Fax Number
304-896-5184
person
Provider Business Mailing Address Details
Address
174 Lmah Center Rd
City
Logan
State
West Virginia
Zip
25601-4058
Phone Number
304-792-7130
Fax Number
304-896-5184
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
22-9154 (West Virginia)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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