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Certified Provider Details:
| PROVIDER NUMBER: | 490051 |
| AGENCY NAME: | WVU Div of Social Work & App. Sci. |
| CONTACT NAME: | Jacki Englehardt |
| ADDRESS: | P O Box 6830 |
| CITY: | Morgantown |
| STATE: | WV |
| ZIP: | 26506 |
| PHONE: | (304) 293-3501 ext. 3109 |
| WEB SITE: | sw.as.wvu.edu/continuing/index.php |
| EMAIL ADDRESS: | Jacki.Englehardt@mail.wvu.edu |
| BSW/MSW NAME: | Jacki Englehardt |
| DUE TO RECERTIFY DATE: | 7/1/2020 |
| COMMENTS: |