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General NPI Number Information
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NPI Number | 1356789309
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Entity Type | Organization
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Legal Business Name | JANE C. PROBST CHILD AND FAMILY COUNSELING, LLC
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Dates
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Enumeration Date | 06/12/2013
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Last Update Date | 06/12/2013
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Provider Practice Location Address
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Address Line | 206 W EDMONDSON ST
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City | CULPEPER
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State | VA
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Zip | 22701-2618
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Country | US
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Telephone | 540-827-7395
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Fax |
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Provider Business Mailing Address
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Address Line | 19223 BELLE CLAIR RD
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City | CULPEPER
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State | VA
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Zip | 22701-8300
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Country | US
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Telephone | 540-827-7395
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JANE C PROBST
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Credential | LCSW
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Telephone | 540-827-7395
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904008147
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License Number State | VA
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