Healthcare Provider Details

I. General information

NPI: 1528105681
Provider Name (Legal Business Name): HARVEST FREEWILL BAPTIST CHILD CARE MINISTRIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RR 1 BOX 136
DUFFIELD VA
24244-9622
US

IV. Provider business mailing address

PO BOX 259
DUFFIELD VA
24244-0259
US

V. Phone/Fax

Practice location:
  • Phone: 276-523-2315
  • Fax: 276-523-7015
Mailing address:
  • Phone: 276-523-2315
  • Fax: 276-523-7015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MR. NEWL K. DOTSON
Title or Position: EXEUCTIVE DIRECTOR
Credential: M.A.
Phone: 276-523-2315