| Shenandoah Creative Counseling For Children And Adolescents | |
|
510 W Broad St Ste H Waynesboro VA 22980-4548 | |
| (540) 471-9022 | |
| (540) 941-8807 |
| Full Name | Shenandoah Creative Counseling For Children And Adolescents |
|---|---|
| Speciality | Clinic/Center |
| Location | 510 W Broad St Ste H, Waynesboro, Virginia |
| Authorized Official Name and Position | Laurie Stone Thomas (MANAGER/OWNER) |
| Authorized Official Contact | 5404719022 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shenandoah Creative Counseling For Children And Adolescents 510 W Broad St Ste H Waynesboro VA 22980-4548 Ph: (540) 471-9022 | Shenandoah Creative Counseling For Children And Adolescents 510 W Broad St Ste H Waynesboro VA 22980-4548 Ph: (540) 471-9022 |
| NPI Number | 1306467147 |
|---|---|
| Provider Enumeration Date | 05/04/2020 |
| Last Update Date | 05/04/2020 |
| Certification Date | 05/04/2020 |
| Medicare PECOS PAC ID | 1355772831 |
|---|---|
| Medicare Enrollment ID | O20200518001075 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306467147 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
| Provider Name | Laurie Stone Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932696952 PECOS PAC ID: 2264863745 Enrollment ID: I20200518001242 |
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