Provider Demographics
NPI:1073029385
Name:CARREFOUR COUNSELING & PLAY THERAPY LLC
Entity Type:Organization
Organization Name:CARREFOUR COUNSELING & PLAY THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BELCHER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:276-266-7513
Mailing Address - Street 1:PO BOX 768
Mailing Address - Street 2:
Mailing Address - City:GALAX
Mailing Address - State:VA
Mailing Address - Zip Code:24333-0768
Mailing Address - Country:US
Mailing Address - Phone:276-266-7513
Mailing Address - Fax:
Practice Address - Street 1:205 W GRAYSON ST
Practice Address - Street 2:
Practice Address - City:GALAX
Practice Address - State:VA
Practice Address - Zip Code:24333-2811
Practice Address - Country:US
Practice Address - Phone:276-383-0400
Practice Address - Fax:855-877-4676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-21
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)