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General NPI Number Information
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NPI Number | 1669410064
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Entity Type | Organization
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Legal Business Name | DANVILLE PITTSYLVANIA COMMUNITY SERVICES
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 425 HAIRSTON ST
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City | DANVILLE
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State | VA
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Zip | 24540-4133
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Country | US
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Telephone | 434-793-4931
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Fax | 434-799-3100
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Provider Business Mailing Address
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Address Line | 425 HAIRSTON ST
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City | DANVILLE
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State | VA
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Zip | 24540-4133
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Country | US
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Telephone | 434-793-4931
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Fax | 434-799-3100
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Authorized Official
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Title or Position | DIRECTOR OF MENTAL HEALTH
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Name | MR. JAMES F BEBEAU
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Credential | LPC
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Telephone | 434-793-4931
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904005264
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License Number State | VA
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