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General NPI Number Information
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NPI Number | 1306443619
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Entity Type | Organization
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Legal Business Name | HELIANTHUS THERAPY SERVICES, LLC
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Dates
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Enumeration Date | 10/08/2020
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Last Update Date | 10/08/2020
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Provider Practice Location Address
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Address Line | 767 MADISON RD STE 112-114
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City | CULPEPER
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State | VA
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Zip | 22701-3379
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Country | US
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Telephone | 540-446-1216
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Fax |
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Provider Business Mailing Address
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Address Line | 80 OAK TREE LN
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City | BRIGHTWOOD
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State | VA
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Zip | 22715-1780
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Country | US
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Telephone | 540-446-1216
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | MRS. AMANDA ANNE STORVICK
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Credential | LPC
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Telephone | 540-446-1216
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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