| Life Source Counseling Center, Inc | |
|
3516 Plank Rd Ste 5c Fredericksburg VA 22407-6861 | |
| (540) 786-3049 | |
| (540) 301-2403 |
| Full Name | Life Source Counseling Center, Inc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 3516 Plank Rd Ste 5c, Fredericksburg, Virginia |
| Authorized Official Name and Position | Crystal Rochelle Jones (OWNER) |
| Authorized Official Contact | 3015233642 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Source Counseling Center, Inc 3516 Plank Rd Ste 5c Fredericksburg VA 22407-6861 Ph: (301) 523-3642 | Life Source Counseling Center, Inc 3516 Plank Rd Ste 5c Fredericksburg VA 22407-6861 Ph: (540) 786-3049 |
| NPI Number | 1801565999 |
|---|---|
| Provider Enumeration Date | 09/10/2021 |
| Last Update Date | 09/10/2021 |
| Certification Date | 09/10/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801565999 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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