=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063009553
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VANOVER COUNSELING, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/30/2020
-----------------------------------------------------
Last Update Date | 07/11/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3148 SAND BRANCH RD
-----------------------------------------------------
City | BLACK MOUNTAIN
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28711-9011
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 912-247-5000
-----------------------------------------------------
Fax | 850-373-4899
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3148 SAND BRANCH RD
-----------------------------------------------------
City | BLACK MOUNTAIN
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28711-9011
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 912-247-5000
-----------------------------------------------------
Fax | 850-373-4899
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JULIA HARRIS HUNT
-----------------------------------------------------
Credential | LCSW, BCD
-----------------------------------------------------
Telephone | 912-247-5000
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------