Tadlock-Jimenez, Bessie Elizabeth

Tadlock-Jimenez, Bessie Elizabeth is an individual health care provider with primary practice located at 1021 Quarrier St Suite 414, Charleston WV 25301-2338. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Tadlock-Jimenez, Bessie Elizabeth can be contacted via phone (304) 340-3676.

Contact Information

Primary practice address
1021 Quarrier St Suite 414 Charleston WV 25301-2338
Phone: (304) 340-3676
Fax: (304) 340-3688
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X BP00943450 West Virginia
Behavioral Health & Social Service Providers / Social Worker 104100000X BP00943450 West Virginia
Behavioral Health & Social Service Providers / Clinical 1041C0700X DP00943450 West Virginia

Profile Details

NPI number 1558702878
LBN Legal business name Tadlock-Jimenez, Bessie Elizabeth
Credentials MSW
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 15th, 2013
Last updated Apr 6th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558702878 NPPES
West Virginia MEDICAID 0023815000

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