Provider Demographics
NPI:1184079642
Name:RINEHART, KARLA KAY (WV-LSW, BS)
Entity type:Individual
Prefix:MRS
First Name:KARLA
Middle Name:KAY
Last Name:RINEHART
Suffix:
Gender:F
Credentials:WV-LSW, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 CHUB RUN RD.
Mailing Address - Street 2:
Mailing Address - City:MT CLARE
Mailing Address - State:WV
Mailing Address - Zip Code:26408
Mailing Address - Country:US
Mailing Address - Phone:304-672-4091
Mailing Address - Fax:
Practice Address - Street 1:27 TROVATO ST.
Practice Address - Street 2:SUITE 103
Practice Address - City:BRIDGEPORT
Practice Address - State:WV
Practice Address - Zip Code:26330
Practice Address - Country:US
Practice Address - Phone:304-623-6300
Practice Address - Fax:304-623-6302
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-03
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAP00942812104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker