Provider Demographics
NPI:1538268198
Name:HOOD, HARRY W (LICENSED PSYCHOLOGIS)
Entity type:Individual
Prefix:MR
First Name:HARRY
Middle Name:W
Last Name:HOOD
Suffix:
Gender:M
Credentials:LICENSED PSYCHOLOGIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 72 BOX 20
Mailing Address - Street 2:
Mailing Address - City:KEYSER
Mailing Address - State:WV
Mailing Address - Zip Code:26726-9602
Mailing Address - Country:US
Mailing Address - Phone:304-788-2148
Mailing Address - Fax:304-788-5604
Practice Address - Street 1:HC 72 BOX 20
Practice Address - Street 2:
Practice Address - City:KEYSER
Practice Address - State:WV
Practice Address - Zip Code:26726-9602
Practice Address - Country:US
Practice Address - Phone:304-788-2148
Practice Address - Fax:304-788-5604
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV456103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0163591000Medicaid
WV0163591000Medicaid