NPI Code Details Logo

NPI 1639870421

NPI 1639870421 : WESTLAKE COUNSELING SERVICES, LLC : MONETA, VA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1639870421
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    WESTLAKE COUNSELING SERVICES, LLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    03/17/2023
-----------------------------------------------------
    Last Update Date     |    09/18/2023
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    74 SCRUGGS RD STE 104 
-----------------------------------------------------
    City                 |    MONETA
-----------------------------------------------------
    State                |    VA
-----------------------------------------------------
    Zip                  |    24121-6330
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    540-912-8204
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    74 SCRUGGS RD STE 104 
-----------------------------------------------------
    City                 |    MONETA
-----------------------------------------------------
    State                |    VA
-----------------------------------------------------
    Zip                  |    24121-6330
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    540-912-8204
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    OWNER
-----------------------------------------------------
    Name                 |     CAROL A SHARP 
-----------------------------------------------------
    Credential           |    LCSW
-----------------------------------------------------
    Telephone            |    860-373-4400
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    1041C0700X
-----------------------------------------------------
    Taxonomy Name        |    Clinical Social Worker
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.