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General NPI Number Information
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NPI Number | 1174627376
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Entity Type | Organization
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Legal Business Name | COMPLETE COUNSELING SERIVCES, INC.
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Dates
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Enumeration Date | 09/11/2006
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Last Update Date | 10/02/2008
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Provider Practice Location Address
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Address Line | 1020 TURKEY MOUNTAIN RD
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City | BEDFORD
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State | VA
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Zip | 24523-6635
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Country | US
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Telephone | 540-586-8146
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Fax | 540-587-7647
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Provider Business Mailing Address
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Address Line | PO BOX 628
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City | BEDFORD
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State | VA
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Zip | 24523-0628
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Country | US
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Telephone | 540-586-8146
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Fax | 540-587-7647
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | MRS. JANIE MARIE MANTOOTH
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Credential | LCSW
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Telephone | 540-586-8146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904003979
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License Number State | VA
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