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General NPI Number Information
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NPI Number | 1982019568
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Entity Type | Organization
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Legal Business Name | LIVING WATER COUNSELING MINISTRY INC.
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Dates
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Enumeration Date | 06/23/2014
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Last Update Date | 06/23/2014
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Provider Practice Location Address
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Address Line | 203 N MAIN ST
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City | HILLSVILLE
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State | VA
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Zip | 24343-1432
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Country | US
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Telephone | 276-779-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 894 ELK SPUR RD
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City | FANCY GAP
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State | VA
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Zip | 24328-4016
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Country | US
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Telephone | 276-779-5100
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Fax |
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Authorized Official
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Title or Position | OWNER- CHRISTIAN COUNSELOR
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Name | MELISSA VALERIE STRICKLAND
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Credential | MS LPC CSAC
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Telephone | 276-779-5100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 0701005403
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License Number State | VA
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