What is Mary Licodo's NPI number?

Mary Licodo's National Provider Identifier (NPI) is 1114673472, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.

What is Mary Licodo's specialty?

Mary Licodo is listed in the NPPES registry with a primary specialty of Community Health Worker (Other Service Providers).

Where is Mary Licodo located?

Mary Licodo's practice location on file with NPPES is 200 Association Dr Ste 130, Charleston, WV 25311-1277.

What is Mary Licodo's phone number?

The practice phone number listed in the NPPES registry for Mary Licodo is (304) 988-4200.

Is Mary Licodo's NPI active?

Yes — Mary Licodo's NPI (1114673472) is active in the NPPES registry as of the last update on 2022-02-25.

IndividualActive

Mary Licodo

NPI 1114673472 · Community Health Worker · Charleston, WV

Mary Licodo is a Community Health Worker provider in Charleston, WV (NPI 1114673472).

Provider details

NPI number: 1114673472
Entity type: Individual
Primary specialty: Community Health WorkerOther Service Providers
Sex: Female
Sole proprietor: Yes

Specialties & taxonomies

Community Health WorkerPrimary172V00000X
Other Service Providers

Profile Score

Established profile(54/100 index)

A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.

Registry tenure38% of score
4 yrs in NPPES registry
Profile completeness38% of score
83% of core fields populated
Practice footprint23% of score
1 documented practice location

Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.

Practice location

200 Association Dr Ste 130

Charleston, WV 25311-1277

Phone: (304) 988-4200

Street-level locationGet directions

More WV providers

Mailing address