MEDICARE: DR. NEDRA VOORHIES LPC

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	101Y00000X	Counselor	10795	TX
2	101YP2500X	Professional Counselor	0701002887	VA

General Provider Information

NPI Number	:	1548319403
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEDRA VOORHIES LPC

Provider Business Mailing Address
First Line	:	10269 KESTREL DR
Second Line	:
City	:	ASHLAND
State	:	VA
Zip	:	23005-1256
Country	:	US
Telephone Number	:	804-502-9111
Fax Number	:

Provider Business Practice Location Address
First Line	:	6366 MECHANICSVILLE TPKE
Second Line	:	SUITE 201A
City	:	MECHANICSVILLE
State	:	VA
Zip	:	23111-4704
Country	:	US
Telephone Number	:	804-502-9111
Fax Number	:	804-622-8051

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	01/30/2013

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