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General NPI Number Information
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NPI Number | 1912592023
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Entity Type | Organization
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Legal Business Name | MOUNTAINSIDE COUNSELING LLC
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Dates
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Enumeration Date | 03/02/2021
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Last Update Date | 12/29/2023
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Provider Practice Location Address
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Address Line | 409 VIRGINIA AVE
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City | HARRISONBURG
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State | VA
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Zip | 22802-3921
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Country | US
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Telephone | 540-742-7550
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Fax | 855-429-4120
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Provider Business Mailing Address
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Address Line | 2439 FAIRVIEW RD
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City | MOUNT CRAWFORD
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State | VA
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Zip | 22841-2901
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Country | US
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Telephone | 540-742-7550
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Fax | 855-429-4120
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Authorized Official
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Title or Position | OWNER/LEAD CLINICIAN
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Name | MR. JEFFREY MCNEIL LOWN
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Credential | LPC
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Telephone | 540-742-7550
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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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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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