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General NPI Number Information
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NPI Number | 1124517131
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Entity Type | Organization
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Legal Business Name | BREAKING THROUGH: A CLINICAL & CONSULTING FIRM, INC.
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Dates
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Enumeration Date | 05/04/2018
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Last Update Date | 05/04/2018
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Provider Practice Location Address
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Address Line | 177 RIVERVIEW DR UPPR LEVEL
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City | DANVILLE
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State | VA
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Zip | 24541-3419
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Country | US
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Telephone | 336-430-7943
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Fax |
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Provider Business Mailing Address
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Address Line | 177 RIVERVIEW DR UPPR LEVEL
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City | DANVILLE
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State | VA
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Zip | 24541-3419
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Country | US
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Telephone | 336-430-7943
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ZYNASIA JASPER
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Credential | LPC
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Telephone | 336-430-7943
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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 | 0701006144
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License Number State | VA
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