Healthcare Provider Details

I. General information

NPI: 1124962964
Provider Name (Legal Business Name): WINGS OF FLIGHT COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1116 BLOSSOM VIEW RD
ARARAT VA
24053-3536
US

IV. Provider business mailing address

1116 BLOSSOM VIEW RD
ARARAT VA
24053-3536
US

V. Phone/Fax

Practice location:
  • Phone: 336-648-4431
  • Fax:
Mailing address:
  • Phone: 336-648-4431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ROBIN MCMILLIAN
Title or Position: LICENSED PROFESSIONAL COUNSELOR
Credential: LPC
Phone: 336-648-4431