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General NPI Number Information
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NPI Number | 1376137398
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Entity Type | Organization
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Legal Business Name | BEACON COUNSELING GROUP
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Dates
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Enumeration Date | 02/22/2021
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Last Update Date | 10/23/2023
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Provider Practice Location Address
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Address Line | 74 SCRUGGS RD STE 104
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City | MONETA
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State | VA
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Zip | 24121-6330
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Country | US
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Telephone | 540-339-6308
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Fax |
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Provider Business Mailing Address
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Address Line | 74 SCRUGGS RD STE 104
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City | MONETA
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State | VA
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Zip | 24121-6330
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Country | US
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Telephone | 540-339-6308
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LYNNE JOHNSON
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Credential | LCSW
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Telephone | 540-339-6308
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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 |
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License Number State |
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