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General NPI Number Information
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NPI Number | 1013186055
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Entity Type | Organization
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Legal Business Name | CHILDREN'S SERVICES OF VIRGINIA, INC.
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Dates
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Enumeration Date | 02/25/2008
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Last Update Date | 08/13/2008
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Provider Practice Location Address
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Address Line | 13230 LOVERS LANE
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City | CULPEPER
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State | VA
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Zip | 22701
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Country | US
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Telephone | 540-829-9612
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Fax | 540-829-9628
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Provider Business Mailing Address
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Address Line | 174 COSTELLO DR
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City | WINCHESTER
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State | VA
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Zip | 22602-4306
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Country | US
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Telephone | 540-662-7007
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Fax | 540-662-5536
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. BASSAM T SABBAGH
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Credential | DIRECTOR
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Telephone | 540-667-0116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 34203001
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License Number State | VA
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