| Louisa Creative Counseling, Llc | |
|
315 Johnny Hall Rd Mineral VA 23117-5202 | |
| (540) 604-3267 | |
| Not Available |
| Full Name | Louisa Creative Counseling, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 315 Johnny Hall Rd, Mineral, Virginia |
| Authorized Official Name and Position | Kristy L Bazzanella (OWNER) |
| Authorized Official Contact | 5406043267 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Louisa Creative Counseling, Llc 7036 Zachary Taylor Hwy Mineral VA 23117-5312 Ph: (540) 604-3267 | Louisa Creative Counseling, Llc 315 Johnny Hall Rd Mineral VA 23117-5202 Ph: (540) 604-3267 |
| NPI Number | 1700337078 |
|---|---|
| Provider Enumeration Date | 10/20/2016 |
| Last Update Date | 10/20/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700337078 | NPI | - | NPPES |
| 601101224 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 0701006594 (Virginia) | Primary |
Louisa Creative Counseling, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 421 Mineral Ave # 192, Mineral, VA 23117 Phone: 540-259-3646 Fax: 540-259-3647 |