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General NPI Number Information
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NPI Number | 1871064469
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Entity Type | Organization
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Legal Business Name | SILVER LINING THERAPEUTIC SERVICES, LLC
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Dates
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Enumeration Date | 12/08/2018
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Last Update Date | 12/08/2018
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Provider Practice Location Address
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Address Line | 2124 JEFFERSON DAVIS HWY STE 202
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City | STAFFORD
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State | VA
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Zip | 22554-7264
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Country | US
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Telephone | 540-426-9813
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Fax | 540-699-6938
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Provider Business Mailing Address
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Address Line | 11 HOPE ROAD SUITE 111, P.O.BOX 222
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City | STAFFORD
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State | VA
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Zip | 22554
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LPC
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Name | RADKA LOUCKA
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Credential | LPC
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Telephone | 540-426-9813
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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