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General NPI Number Information
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NPI Number | 1457543035
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Entity Type | Organization
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Legal Business Name | VISION FOUNDATION COUNSELING CENTER, INC
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Dates
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Enumeration Date | 08/16/2007
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Last Update Date | 08/16/2007
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Provider Practice Location Address
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Address Line | 1216 WHISPERING PINES RD
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City | ALBANY
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State | GA
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Zip | 31707-3562
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Country | US
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Telephone | 229-435-1729
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Fax | 229-435-1720
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Provider Business Mailing Address
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Address Line | 1216 WHISPERING PINES RD
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City | ALBANY
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State | GA
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Zip | 31707-3562
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Country | US
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Telephone | 229-435-1729
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Fax | 229-435-1720
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RODERICK WILCOX
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Credential | LCSW
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Telephone | 229-435-1729
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | #214
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License Number State | GA
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