Healthcare Provider Details

I. General information

NPI: 1770522559
Provider Name (Legal Business Name): LIFELINE SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

390 COMMERCE DR SUITE D
ABINGDON VA
24211-3876
US

IV. Provider business mailing address

390 COMMERCE DR SUITE D
ABINGDON VA
24211-3876
US

V. Phone/Fax

Practice location:
  • Phone: 276-623-2444
  • Fax:
Mailing address:
  • Phone: 276-623-2444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0701001513
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701001513
License Number StateVA

VIII. Authorized Official

Name: MR. DAVID RICHARD HEVER
Title or Position: CO-DIRECTOR
Credential: LPC
Phone: 276-623-2444