MEDICARE: DALEVILLE FAMILY COUNSELING, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1114754926
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DALEVILLE FAMILY COUNSELING, INC

Provider Business Mailing Address
First Line	:	35 LAKE AVE
Second Line	:
City	:	SALEM
State	:	VA
Zip	:	24153-3237
Country	:	US
Telephone Number	:	540-591-9911
Fax Number	:	540-591-9914

Provider Business Practice Location Address
First Line	:	35 LAKE AVE
Second Line	:
City	:	SALEM
State	:	VA
Zip	:	24153-3237
Country	:	US
Telephone Number	:	540-591-9911
Fax Number	:	540-591-9914

Authorized Official
Title or Position	:	OWNER/THERAPIST
Name	:	DANDREA TRAINOR WASHBURN
Credential	:	LPC
Telephone Number	:	540-591-9911

Provider Enumeration Date	:	09/16/2024
Last Update Date	:	02/19/2026

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