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General NPI Number Information
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NPI Number | 1750609152
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Entity Type | Organization
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Legal Business Name | HANCOCK CONSORTIUM
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Dates
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Enumeration Date | 05/10/2010
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Last Update Date | 06/25/2010
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Provider Practice Location Address
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Address Line | 17099 MOUNTAIN RD
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City | MONTPELIER
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State | VA
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Zip | 23192-2549
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Country | US
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Telephone | 804-883-5134
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 37
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City | MONTPELIER
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State | VA
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Zip | 23192-0037
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Country | US
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Telephone | 804-883-5134
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MARGO ELIZABETH HANCOCK
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Credential | L.P.C
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Telephone | 804-883-5134
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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 | 0701004671
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0701004671
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | 0701004671
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701004671
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License Number State | VA
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