| Living Water Counseling Center, Inc. | |
|
137 Laxton Rd Suite 250 Lynchburg VA 24502-3144 | |
| (434) 473-7458 | |
| Not Available |
| Full Name | Living Water Counseling Center, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 137 Laxton Rd, Lynchburg, Virginia |
| Authorized Official Name and Position | Brian Scott Wilkerson (PRESIDENT AND CEO) |
| Authorized Official Contact | 4345349329 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Living Water Counseling Center, Inc. 412 Runner Stone Dr Evington VA 24550-4330 Ph: () - | Living Water Counseling Center, Inc. 137 Laxton Rd Suite 250 Lynchburg VA 24502-3144 Ph: (434) 473-7458 |
| NPI Number | 1619264892 |
|---|---|
| Provider Enumeration Date | 07/07/2011 |
| Last Update Date | 11/15/2011 |
| Medicare PECOS PAC ID | 9537312186 |
|---|---|
| Medicare Enrollment ID | O20130109000456 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619264892 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (Virginia) | Secondary |
| 251S00000X | Community/behavioral Health | 1913 (Virginia) | Primary |
| Provider Name | Dana Marie Wilkerson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891122131 PECOS PAC ID: 7416100060 Enrollment ID: I20240415003181 |
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