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General NPI Number Information
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NPI Number | 1215930573
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Entity Type | Organization
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Legal Business Name | NORTHWESTERN COMMUNITY SERVICES BOARD
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 209 W CRISER RD STE 100
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City | FRONT ROYAL
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State | VA
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Zip | 22630-2360
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Country | US
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Telephone | 540-636-2931
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Fax | 540-636-2933
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Provider Business Mailing Address
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Address Line | 209 W CRISER RD STE 300
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City | FRONT ROYAL
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State | VA
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Zip | 22630-2360
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Country | US
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Telephone | 540-636-4250
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Fax | 540-636-7171
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Authorized Official
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Title or Position | CEO
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Name | ELLEN DEGRAFF HARRISON
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Credential |
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Telephone | 540-434-1941
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | VA
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Taxonomy #6
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State | VA
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Taxonomy #7
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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