MR. GARY LEE MCDERMENT PRSS NPI 1477331163

NPI Information

  • NPI: 1477331163
  • Provider Name: MR. GARY LEE MCDERMENT, PRSS
  • Classification: Peer Specialist - 175T00000X
  • Entity Type: Individual
  • Address: 802 OAK ST
    KENOVA, WV
    ZIP 25530
  • Phone: (304) 908-1056

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NPI Details

MR. Gary Lee Mcderment, PRSS is a peer specialist in Kenova, WV. The provider is 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. MR. Gary Lee Mcderment, PRSS NPI is 1477331163. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

802 OAK ST
KENOVA, WV
ZIP 25530-519
Phone: (304) 908-1056

The enumeration date for this NPI number is 9/15/2023 and was last updated on 2/21/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1175T00000XPeer Specialist23-9188WEST VIRGINIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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