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Certified Provider Details:
| PROVIDER NUMBER: | 490047 |
| AGENCY NAME: | Concord University Social Work Dept. |
| CONTACT NAME: | Sean Noland Coordinator |
| ADDRESS: | Campus Box D-107- PO Box 1000 |
| CITY: | Athens |
| STATE: | WV |
| ZIP: | 24712 |
| PHONE: | (304) 384-6279 ext. 5218 |
| WEB SITE: | |
| EMAIL ADDRESS: | continuinged@concord.edu |
| BSW/MSW NAME: | John David Smith |
| DUE TO RECERTIFY DATE: | 7/1/2020 |
| COMMENTS: |