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General NPI Number Information
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NPI Number | 1457397457
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Entity Type | Organization
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Legal Business Name | FAMILY SERVICE OF ROANOKE VALLEY
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 11/03/2023
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Provider Practice Location Address
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Address Line | 360 CAMPBELL AVE SW
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City | ROANOKE
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State | VA
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Zip | 24016-3625
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Country | US
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Telephone | 540-563-5316
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Fax | 540-563-5254
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Provider Business Mailing Address
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Address Line | 360 CAMPBELL AVE SW
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City | ROANOKE
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State | VA
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Zip | 24016-3625
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Country | US
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Telephone | 540-563-5316
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Fax | 540-563-5254
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Authorized Official
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Title or Position | CEO
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Name | MR. LINDA HENTSCHEL
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Credential |
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Telephone | 540-563-5316
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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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Taxonomy #2
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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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