Healthcare Provider Details

I. General information

NPI: 1104858653
Provider Name (Legal Business Name): HANOVER COUNTY BOARD OF SUPERVISORS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 05/14/2024
Certification Date: 05/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12300 WASHINGTON HWY
ASHLAND VA
23005-7646
US

IV. Provider business mailing address

12300 WASHINGTON HWY
ASHLAND VA
23005-7646
US

V. Phone/Fax

Practice location:
  • Phone: 804-365-4222
  • Fax: 804-365-4252
Mailing address:
  • Phone: 804-365-4222
  • Fax: 804-365-4252

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: MRS. IVY T SAGER
Title or Position: EXECUTIVE DIRECTOR
Credential: MSW
Phone: 804-365-4289