| Middle Peninsula Counseling Services Llc | |
|
12156 Fox Mill Run Ln Ashland VA 23005-3056 | |
| (804) 201-3604 | |
| Not Available |
| Full Name | Middle Peninsula Counseling Services Llc |
|---|---|
| Speciality | Counselor |
| Location | 12156 Fox Mill Run Ln, Ashland, Virginia |
| Authorized Official Name and Position | Elizabeth Ellis Schubert (SOLE MEMBER) |
| Authorized Official Contact | 8042013604 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Middle Peninsula Counseling Services Llc Po Box 611 North VA 23128-0611 Ph: (804) 201-3604 | Middle Peninsula Counseling Services Llc 12156 Fox Mill Run Ln Ashland VA 23005-3056 Ph: (804) 201-3604 |
| NPI Number | 1295572246 |
|---|---|
| Provider Enumeration Date | 07/09/2024 |
| Last Update Date | 07/09/2024 |
| Certification Date | 07/09/2024 |
| Medicare PECOS PAC ID | 7810434800 |
|---|---|
| Medicare Enrollment ID | O20240808001452 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295572246 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Elizabeth Schubert |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356105449 PECOS PAC ID: 4082151071 Enrollment ID: I20240808001764 |
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