Healthcare Provider Details

I. General information

NPI: 1124350921
Provider Name (Legal Business Name): SOUND MIND COUNSELING MINISTRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2010
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 CEDAR VALLEY DRIVE SUITE 4
CEDAR BLUFF VA
24609
US

IV. Provider business mailing address

1100 CEDAR VALLEY DR SUITE 4
CEDAR BLUFF VA
24609
US

V. Phone/Fax

Practice location:
  • Phone: 276-698-0073
  • Fax: 276-964-0052
Mailing address:
  • Phone: 276-698-0073
  • Fax: 276-964-0052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name: DR. VALERIE DENISE BURRESS
Title or Position: CHRISTIAN COUNSELOR
Credential: PH.D
Phone: 276-494-4036