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General NPI Number Information
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NPI Number | 1538403910
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Entity Type | Individual
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Provider Name | TINA LANE SHEETS LPC
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Gender | Female
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Dates
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Enumeration Date | 11/26/2012
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Last Update Date | 11/26/2012
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Provider Practice Location Address
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Address Line | 641 CARROLLWOOD DR
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City | WOODLAWN
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State | VA
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Zip | 24381-3539
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Country | US
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Telephone | 276-728-2070
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Fax | 276-728-2161
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Provider Business Mailing Address
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Address Line | 393 N MAIN ST
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City | SPARTA
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State | NC
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Zip | 28675-8896
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Country | US
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Telephone | 336-372-6083
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Fax | 336-372-1930
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701003110
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0710101457
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License Number State | VA
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