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General NPI Number Information
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NPI Number | 1821181736
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Entity Type | Organization
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Legal Business Name | LILLIAN H OGLE LCSW PC
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 03/04/2020
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Provider Practice Location Address
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Address Line | 468 E. MAIN ST., SUITE 100 JOHNSON CENTER
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City | ABINGDON
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State | VA
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Zip | 24210
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Country | US
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Telephone | 276-628-2140
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Fax | 276-628-2140
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Provider Business Mailing Address
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Address Line | PO BOX 394
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City | GLADE SPRING
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State | VA
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Zip | 24340-0394
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Country | US
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Telephone | 276-429-2114
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Fax | 276-429-2120
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Authorized Official
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Title or Position | PRESIDENT
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Name | LILLIAN H OGLE
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Credential | LCSW
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Telephone | 276-429-2114
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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 | 0904001976
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License Number State | VA
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