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NPI Profile for KYLE FETHEROLF in HUNTINGTON, WV.
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.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Other Service Providers |
175T00000X | |||
Addiction (Substance Use Disorder) |
101YA0400X | |||
Case Manager/Care Coordinator |
171M00000X |
| NPI # | 1316458912 |
|
| Status | Active | |
| Credentials | PRSS | |
| Entity | Individual | |
| Enumeration date | 10/23/2017 | |
| Last updated | 10/27/2021 - About 5 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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KYLE FETHEROLF
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KYLE FETHEROLF, PRSS