Healthcare Provider Details

I. General information

NPI: 1871043539
Provider Name (Legal Business Name): HOWERTON COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2016
Last Update Date: 01/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 W MAIN ST
DANVILLE VA
24541-2823
US

IV. Provider business mailing address

150 W MAIN ST
DANVILLE VA
24541-2823
US

V. Phone/Fax

Practice location:
  • Phone: 434-791-2144
  • Fax: 434-792-0259
Mailing address:
  • Phone: 434-791-2144
  • Fax: 434-792-0259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701006649
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-15-04593
License Number StateVA

VIII. Authorized Official

Name: MRS. ANISSA HOWERTON
Title or Position: COUNSELOR
Credential: MA, LPC
Phone: 434-709-7167