Provider Demographics
NPI:1487756078
Name:HALTERMAN, DENISE LOUISE (LPC, LCPC, LCADC)
Entity type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:LOUISE
Last Name:HALTERMAN
Suffix:
Gender:F
Credentials:LPC, LCPC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3576 UPPER LAUREL DALE RD
Mailing Address - Street 2:
Mailing Address - City:NEW CREEK
Mailing Address - State:WV
Mailing Address - Zip Code:26743-8755
Mailing Address - Country:US
Mailing Address - Phone:304-813-4647
Mailing Address - Fax:
Practice Address - Street 1:1355 LYNMAR ST
Practice Address - Street 2:
Practice Address - City:KEYSER
Practice Address - State:WV
Practice Address - Zip Code:26726-2113
Practice Address - Country:US
Practice Address - Phone:304-788-2484
Practice Address - Fax:304-788-2484
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCA436101YA0400X
WV1775101YP2500X
MDLC2062101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)