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General NPI Number Information
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NPI Number | 1255042909
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Entity Type | Organization
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Legal Business Name | VIRGINIA VALLEY COUNSELING LLC
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Dates
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Enumeration Date | 12/13/2022
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Last Update Date | 12/13/2022
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Provider Practice Location Address
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Address Line | 4835 WATERLICK RD STE A
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City | FOREST
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State | VA
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Zip | 24551-1696
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Country | US
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Telephone | 440-635-6254
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Fax |
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Provider Business Mailing Address
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Address Line | 4835 WATERLICK RD STE A
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City | FOREST
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State | VA
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Zip | 24551-1696
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Country | US
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Telephone | 440-635-6254
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICIAN
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Name | OLIVIA RUTH ACREE
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Credential |
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Telephone | 440-635-6254
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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 |
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License Number State |
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Taxonomy #2
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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 |
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