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Tyson Wade Kincaid
Peer Specialist in Beckley, West Virginia
NPI 1366150153

Tyson Wade Kincaid is a Peer Specialist based in Beaver, WV. Tyson Wade Kincaid practices in Beckley, WV. The NPI Number for Tyson Wade Kincaid is 1366150153 and holds a License No. (West Virginia).

The current practice location address for Tyson Wade Kincaid is 345 Prince St Ste 1, Beckley, WV and can be reached out via phone at 304-254-8709.

Location: 345 Prince St Ste 1, Beckley, WV, 25813-9547
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1366150153
Provider Name
Tyson Wade Kincaid
Credential
Provider Entity Type
Individual
Gender
Male
Address
345 Prince St Ste 1, Beckley, WV, 25813-9547
Phone Number
304-254-8709
Fax Number
Provider Enumeration Date
11/09/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
345 Prince St Ste 1
City
Beckley
State
West Virginia
Zip
25801-4515
Phone Number
304-254-8709
Fax Number
person
Provider Business Mailing Address Details
Address
345 Prince St Ste 1
City
Beckley
State
West Virginia
Zip
25801-4515
Phone Number
304-254-8709
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
(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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