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General NPI Number Information
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NPI Number | 1861471344
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Entity Type | Organization
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Legal Business Name | ABINGDON CHRISTIAN COUNSELING
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Dates
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Enumeration Date | 01/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 274 PARK ST
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City | ABINGDON
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State | VA
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Zip | 24212
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Country | US
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Telephone | 276-971-9715
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Fax | 276-739-7926
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Provider Business Mailing Address
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Address Line | PO BOX 1441
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City | ABINGDON
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State | VA
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Zip | 24212-1441
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Country | US
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Telephone | 276-971-9715
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Fax | 276-739-7926
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. WILLIAM B HAYNES JR.
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Credential | M ED LPC
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Telephone | 276-971-9715
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0701001325
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License Number State | VA
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