MEDICARE: SILVER LININGS COUNSELING, LLC

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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1174095186
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SILVER LININGS COUNSELING, LLC

Provider Business Mailing Address
First Line	:	7336 MAPLE CT
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24018-9071
Country	:	US
Telephone Number	:	540-293-7237
Fax Number	:

Provider Business Practice Location Address
First Line	:	36 W CLEVELAND AVE
Second Line	:
City	:	VINTON
State	:	VA
Zip	:	24179-2508
Country	:	US
Telephone Number	:	540-293-7237
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. STACIE LONG
Credential	:	LPC
Telephone Number	:	540-293-7237

Provider Enumeration Date	:	01/02/2019
Last Update Date	:	01/02/2019

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