| Buckhorn Lane Counseling, Pllc | |
|
2217 Princess Anne St Suite 105-5 Fredericksburg VA 22401-3382 | |
| (540) 371-1006 | |
| (540) 371-1911 |
| Full Name | Buckhorn Lane Counseling, Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2217 Princess Anne St, Fredericksburg, Virginia |
| Authorized Official Name and Position | Rachel H Edmunds (OWNER, SOLE PROVIDER) |
| Authorized Official Contact | 5403711006 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Buckhorn Lane Counseling, Pllc 2217 Princess Anne St Suite 105-5 Fredericksburg VA 22401-3382 Ph: (540) 371-1006 | Buckhorn Lane Counseling, Pllc 2217 Princess Anne St Suite 105-5 Fredericksburg VA 22401-3382 Ph: (540) 371-1006 |
| NPI Number | 1235433699 |
|---|---|
| Provider Enumeration Date | 12/28/2010 |
| Last Update Date | 01/03/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235433699 | NPI | - | NPPES |
| 11902767 | Other | CAQH | |
| 1093951501 | Medicaid | VA | |
| 0904006912 | Other | VA | VA LCSW LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 0904006912 (Virginia) | Primary |
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