Healthcare Provider Details

I. General information

NPI: 1891859864
Provider Name (Legal Business Name): WYNDHURST COUNSELING CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

371 OAKDALE CIRCLE
LYNCHBURG VA
24502-2889
US

IV. Provider business mailing address

371 OAKDALE CIRCLE
LYNCHBURG VA
24502-2889
US

V. Phone/Fax

Practice location:
  • Phone: 434-237-2655
  • Fax: 434-237-4422
Mailing address:
  • Phone: 434-237-2655
  • Fax: 434-237-4422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0701002826
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. CHARLES W RODGERS
Title or Position: PARTNER
Credential: LPC
Phone: 434-237-2655