| Life Line Counseling Center | |
|
10374 Democracy Ln Ste A Fairfax VA 22030-2557 | |
| (703) 691-3029 | |
| (703) 691-7410 |
| Full Name | Life Line Counseling Center |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 10374 Democracy Ln Ste A, Fairfax, Virginia |
| Authorized Official Name and Position | George Lyndon Swanberg (PRESIDENT) |
| Authorized Official Contact | 7036913029 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Line Counseling Center 4308 Beaver Dam Rd Jeffersonton VA 22724-2001 Ph: (540) 347-9531 | Life Line Counseling Center 10374 Democracy Ln Ste A Fairfax VA 22030-2557 Ph: (703) 691-3029 |
| NPI Number | 1437223922 |
|---|---|
| Provider Enumeration Date | 11/17/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437223922 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 0718000188 (Virginia) | Primary |
| 1041C0700X | Social Worker - Clinical | 0904006265 (Virginia) | Primary |
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