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400 Roanoke St Christiansburg VA 24073-3139 | |
| (540) 381-6215 | |
| (540) 381-6216 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 400 Roanoke St, Christiansburg, Virginia |
| Authorized Official Name and Position | Angela Marie Mcgoldrick (OWNER/DIRECTOR) |
| Authorized Official Contact | 5403816215 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
400 Roanoke St Christiansburg VA 24073-3139 Ph: (540) 381-6215 | 400 Roanoke St Christiansburg VA 24073-3139 Ph: (540) 381-6215 |
| NPI Number | 1093047136 |
|---|---|
| Provider Enumeration Date | 01/30/2010 |
| Last Update Date | 02/29/2024 |
| Certification Date | 02/29/2024 |
| Medicare PECOS PAC ID | 7517118532 |
|---|---|
| Medicare Enrollment ID | O20121121000041 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093047136 | NPI | - | NPPES |
| 1679658587 | Medicaid | VA | |
| 600651686 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 0701004405 (Virginia) | Primary |
| Provider Name | Erin M Sullivan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730155292 PECOS PAC ID: 3274568936 Enrollment ID: I20050930000397 |
| Provider Name | Deanna Bailey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689318123 PECOS PAC ID: 9335525732 Enrollment ID: I20221010000544 |
| Provider Name | Arielle Pollack |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467910133 PECOS PAC ID: 5092165910 Enrollment ID: I20231219000749 |
| Provider Name | Andrew G Burns |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962568584 PECOS PAC ID: 2769820224 Enrollment ID: I20240402004411 |
| Provider Name | Angela Gasell Cardenas |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427607498 PECOS PAC ID: 7719328863 Enrollment ID: I20240507004125 |
| Provider Name | Cynthia Jane Skidmore-blevins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902937139 PECOS PAC ID: 4486185337 Enrollment ID: I20241002001512 |
| Provider Name | Makenna Grayson Sands |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104523497 PECOS PAC ID: 9931632874 Enrollment ID: I20241030001917 |
That Counseling Place, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 930 Cambria St Ne Ste 100, Christiansburg, VA 24073 Phone: 540-944-4994 Fax: 540-944-6446 | |
Season Childress Lpc Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 Roanoke St, Christiansburg, VA 24073 Phone: 540-392-5374 | |
Misty Cox Henderson, Lcsw, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 602 Radford St, Christiansburg, VA 24073 Phone: 540-230-8589 |