| Justin C Blackburn, LPC | |
|
1520 Slate Creek Rd Ste 201, Grundy, VA 24614-6975 | |
| (276) 242-2001 | |
| (276) 312-8337 |
| Full Name | Justin C Blackburn |
|---|---|
| Gender | Male |
| Speciality | Counselor |
| Location | 1520 Slate Creek Rd Ste 201, Grundy, Virginia |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366106312 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 0701010929 (Virginia) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Justin C Blackburn, LPC Po Box 390, Huntington, WV 25708-0390 Ph: (304) 696-1636 | Justin C Blackburn, LPC 1520 Slate Creek Rd Ste 201, Grundy, VA 24614-6975 Ph: (276) 242-2001 |
Destiny Rose Goodson, CSAC SUPERVISEE Counselor Medicare: Not Enrolled in Medicare Practice Location: 1520 Slate Creek Rd Ste 201, Grundy, VA 24614 Phone: 276-242-2001 | |
Mrs. Susan Buskill Fogg, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 19873 Riverside Drive, Grundy, VA 24614 Phone: 276-210-4618 | |
Robert Auville, M.ED., CSAC, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 19873 Riverside Drive, Grundy, VA 24614 Phone: 276-244-1380 |