Provider Demographics
NPI:1679959738
Name:TUNICK, ROY HARVEY (EDD)
Entity type:Individual
Prefix:DR
First Name:ROY
Middle Name:HARVEY
Last Name:TUNICK
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 REGENCY CT
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-3685
Mailing Address - Country:US
Mailing Address - Phone:304-599-6755
Mailing Address - Fax:
Practice Address - Street 1:16 REGENCY CT
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-3685
Practice Address - Country:US
Practice Address - Phone:304-599-6755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV412103T00000X
WV22041103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV412OtherLICENSED PSYCHOLOGIST