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General NPI Number Information
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NPI Number | 1215534284
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Entity Type | Organization
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Legal Business Name | OPEN HEARTS CHRISTIAN COUNSELING
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Dates
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Enumeration Date | 10/02/2020
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Last Update Date | 10/02/2020
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Provider Practice Location Address
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Address Line | 2530 CARRIAGE LN APT 1D
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-7925
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Country | US
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Telephone | 703-593-1061
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Fax |
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Provider Business Mailing Address
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Address Line | 2530 CARRIAGE LN APT 1D
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-7925
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Country | US
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Telephone | 703-593-1061
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | BRANDON CHRISTOPHER FITZGERALD-HOLLEY
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Credential | BE.D,MDIV,MPA, DAS
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Telephone | 804-482-6503
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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