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General NPI Number Information
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NPI Number | 1457419285
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Entity Type | Organization
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Legal Business Name | ASSOCIATED COUNSELING SERVICES, INC.
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 09/08/2007
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Provider Practice Location Address
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Address Line | 118 VETERANS DR
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City | RICHLANDS
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State | VA
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Zip | 24641-2764
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Country | US
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Telephone | 304-323-3511
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Fax | 304-324-0827
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Provider Business Mailing Address
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Address Line | PO BOX 387
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City | TAZEWELL
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State | VA
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Zip | 24651-0387
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Country | US
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Telephone | 304-323-3511
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Fax | 304-324-0827
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. LEONARD ANDREW STEWARD JR.
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Credential | PH.D.
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Telephone | 304-323-3511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810002531
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License Number State | VA
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