INTENSIVE TRAUMA THERAPY INC (NPI# 1194820118) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194820118 |
| Entity Type | Organization |
| Organization Name | INTENSIVE TRAUMA THERAPY INC |
| Practice Address |
314 Scott Avenue Morgantown WV 26508 |
| Practice Telephone | 3042912912 |
| Practice Fax Number | 3042912918 |
| Mailing Telephone | 3042912912 |
| Mailing Fax Number | 3042912918 |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. LINDA GANTT (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3042912912 |
| Authorized Official Credential | PHD ATRBC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 103TC1900X |
Psychologist Specialization: Counseling |
PC001898 | PA | Behavioral Health & Social Service Providers |
| X | 1041C0700X |
Social Worker Specialization: Clinical |
DP00939059 | WV | Behavioral Health & Social Service Providers |
| X | 1041C0700X |
Social Worker Specialization: Clinical |
DP00942623 | WV | Behavioral Health & Social Service Providers |
| X | 221700000X | Art Therapist | 79001 | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
314 SCOTT AVENUE |
| City | MORGANTOWN |
| State | WV |
| Zip Code | 26508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720164908 | Linda M Gantt | Psychologist | 314 Scott Avenue, Morgantown, WV 26508 | 2006-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750989026 | Ruth Gibson | Technician | 4 Elpaso Ave, Morgantown, WV 26508 | 2020-10-09 |
| 1518565845 | Anne Jiang | Pharmacist | 7000 Mid Atlantic Dr., Morgantown, WV 26508 | 2020-10-09 |
| 1396356283 | Jessica Dawn Taylor | Technician | Lot 128 Healthy Heights Village, Morgantown, WV 26508 | 2020-08-13 |
| 1992297733 | Jeffrey G Minchau Dds Ms | Dentist | 9000 Coombs Farm Dr, Ste 304, Morgantown, WV 26508 | 2018-06-06 |
| 1346796257 | Gregory Ice | Social Worker | 1627 Grafton Rd, Morgantown, WV 26508 | 2016-08-31 |
| 1306242540 | Mountaineer Psychological Services | Community/Behavioral Health | 4000 Coombs Farm Drive, Bldg D Unit 102, Morgantown, WV 26508 | 2014-11-17 |
| 1750722906 | Tingler Rx | Pharmacy | 889 Venture Drive, Suite 2, Morgantown, WV 26508 | 2013-07-16 |
| 1881033983 | Amy Rodgers Smith | Music Therapist | 714 Venture Drive #115, Morgantown, WV 26508 | 2013-06-21 |
| 1013250588 | Walid Radwan | Student in an Organized Health Care Education/Training Program | 1121 Eagle Run Road, Morgantown, WV 26508 | 2013-04-02 |
| 1467727040 | Sara Lyndsey Disimone | Counselor | 3000 Coombs Farm Road, Suite 102, Morgantown, WV 26508 | 2012-03-15 |
| Find all providers in zip 26508 | ||||
| Taxonomy Code | 103TC1900X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Counseling |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578836029 | Catherine Ann Yura | Psychologist | Student Services Building, Morgantown, WV 26506 | 2012-02-14 |
| 1770734972 | Traci Aaron Berry-harris | Psychologist | 1224 B Pineview Dr, Morgantown, WV 26505-2714 | 2008-10-06 |
| 1417922360 | Keith Lee Rieder | Psychologist | 1061 Maple Dr, Suite 1, Morgantown, WV 26505-2814 | 2006-02-22 |
| 1003422924 | Yaping Huang Anderson | Psychologist | 933 Cheat Rd, Morgantown, WV 26508-5631 | 2020-09-16 |
| 1578181533 | Narayan Gold | Psychologist | 933 Cheat Rd, Morgantown, WV 26508-5631 | 2020-07-07 |
| 1609222348 | Teresa Stire | Psychologist | 1224 Pineview Dr Ste B, Morgantown, WV 26505-0708 | 2016-05-12 |
| 1447523360 | Edard F Etzel | Psychologist | 700 College Ave, Morgantown, WV 26505-6422 | 2012-02-23 |
| 1699844845 | Marion P Kostka | Psychologist | 1553 Stewartstown Rd, Morgantown, WV 26505-2947 | 2006-11-06 |
| 1720164908 | Linda M Gantt | Psychologist | 314 Scott Avenue, Morgantown, WV 26508 | 2006-10-31 |
| 1124097456 | Lisa C Hamilton | Psychologist | 1062 Maple Dr, Suite 1, Morgantown, WV 26505-2815 | 2006-03-17 |
| Find all providers in MORGANTOWN | ||||
| City | MORGANTOWN |
| Zip Code | 26508 |
Please comment or provide details below to improve the information on INTENSIVE TRAUMA THERAPY INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.