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General NPI Number Information
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NPI Number | 1508833294
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Entity Type | Organization
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Legal Business Name | BLUE RIDGE BEHAVIORAL HEALTHCARE
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Dates
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Enumeration Date | 03/02/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 611 MCDOWELL AVE NW
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City | ROANOKE
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State | VA
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Zip | 24016-1225
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Country | US
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Telephone | 540-343-2425
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Fax | 540-343-9543
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Provider Business Mailing Address
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Address Line | 301 ELM AVE SW
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City | ROANOKE
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State | VA
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Zip | 24016-4001
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Country | US
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Telephone | 540-345-9841
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Fax | 540-527-2900
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Authorized Official
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Title or Position | THERAPIST
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Name | MS. GAY CAROL MOFFIT
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Credential | LPC; LSATP
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Telephone | 540-343-2425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 0701002813
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 0718000075
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License Number State | VA
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