Healthcare Provider Details

I. General information

NPI: 1306906102
Provider Name (Legal Business Name): GENERATIONS COUNSELING CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 10/04/2022
Certification Date: 10/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3153 JUNCTION RD
STRASBURG VA
22657-4110
US

IV. Provider business mailing address

3153 JUNCTION RD
STRASBURG VA
22657-4110
US

V. Phone/Fax

Practice location:
  • Phone: 540-931-1776
  • Fax:
Mailing address:
  • Phone: 540-931-1776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904006214
License Number StateVA

VIII. Authorized Official

Name: DONNA STEFFEY WILSON
Title or Position: OWNER
Credential: LCSW
Phone: 540-931-1776