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General NPI Number Information
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NPI Number | 1215398698
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Entity Type | Organization
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Legal Business Name | DANDELION COUNSELING
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Dates
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Enumeration Date | 03/14/2016
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Last Update Date | 06/07/2024
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Provider Practice Location Address
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Address Line | 217 E CHURCH ST
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City | MARTINSVILLE
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State | VA
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Zip | 24112-2807
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Country | US
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Telephone | 828-238-4412
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Fax |
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Provider Business Mailing Address
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Address Line | 15 CLEVELAND AVE STE 11
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City | MARTINSVILLE
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State | VA
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Zip | 24112-2926
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Country | US
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Telephone | 762-634-8304
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH COUNSELOR
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Name | STEPHANIE STULTZ SHERRILL
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Credential | LPC
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Telephone | 828-238-4412
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 0701006438
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License Number State | VA
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