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General NPI Number Information
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NPI Number | 1528339231
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Entity Type | Organization
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Legal Business Name | GUIDING LIVES, INC
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Dates
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Enumeration Date | 01/26/2012
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Last Update Date | 01/26/2012
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Provider Practice Location Address
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Address Line | 4121 CAMERON RD
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City | HOPEWELL
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State | VA
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Zip | 23860-1670
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Country | US
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Telephone | 804-415-7606
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Fax | 804-415-7606
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Provider Business Mailing Address
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Address Line | 4121 CAMERON RD
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City | HOPEWELL
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State | VA
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Zip | 23860-1670
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Country | US
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Telephone | 804-415-7606
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Fax | 804-415-7606
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. SAMARIA MELVINA LEWIS
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Credential | M.ED
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Telephone | 434-378-1306
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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 | 1216
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License Number State | VA
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