Healthcare Provider Details

I. General information

NPI: 1013379676
Provider Name (Legal Business Name): BETTER DAYS COUNSELING SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2016
Last Update Date: 03/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4222 FORTUNA CENTER PLZ
DUMFRIES VA
22025-1515
US

IV. Provider business mailing address

3324 DONDIS CREEK DR
TRIANGLE VA
22172-2088
US

V. Phone/Fax

Practice location:
  • Phone: 571-247-4011
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: RICARDO HICKS
Title or Position: OWNER
Credential: LPC, CADC
Phone: 571-247-4011