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General NPI Number Information
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NPI Number | 1396407094
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Entity Type | Organization
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Legal Business Name | LUNSFORD BEHAVIORAL CONSULTING & YOGA, LLC
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Dates
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Enumeration Date | 10/10/2021
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Last Update Date | 10/27/2022
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Provider Practice Location Address
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Address Line | 1419 WILLIAM ST
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-5423
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Country | US
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Telephone | 540-219-4440
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Fax |
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Provider Business Mailing Address
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Address Line | 104 BEATSON ST
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-5636
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MATTHEW RYAN LUNSFORD
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Credential | M.ED., MS, BCBA, LBA
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Telephone | 540-219-4440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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