| Blue Ridge Counseling Center, Plc | |
|
335 Westside Station Dr Winchester VA 22601-2840 | |
| (540) 662-7555 | |
| (540) 662-9105 |
| Full Name | Blue Ridge Counseling Center, Plc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 335 Westside Station Dr, Winchester, Virginia |
| Authorized Official Name and Position | James Robert Lizer (OWNER) |
| Authorized Official Contact | 5406627555 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Ridge Counseling Center, Plc 335 Westside Station Dr Winchester VA 22601-2840 Ph: (540) 662-7555 | Blue Ridge Counseling Center, Plc 335 Westside Station Dr Winchester VA 22601-2840 Ph: (540) 662-7555 |
| NPI Number | 1881606564 |
|---|---|
| Provider Enumeration Date | 08/12/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 0446311856 |
|---|---|
| Medicare Enrollment ID | O20081203000891 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881606564 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Brenda J Johnston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730333964 PECOS PAC ID: 0143385039 Enrollment ID: I20090209000621 |
| Provider Name | Carol B Oleary |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1184627424 PECOS PAC ID: 6507927910 Enrollment ID: I20101117000200 |
| Provider Name | Maneika D Shifflett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699199471 PECOS PAC ID: 1759505332 Enrollment ID: I20140623000910 |
| Provider Name | Tina J Myer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174911887 PECOS PAC ID: 5698090041 Enrollment ID: I20150206001176 |
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