Provider Demographics
NPI:1083792261
Name:CLARKSVILLE COUNSELING CENTER, PLC
Entity Type:Organization
Organization Name:CLARKSVILLE COUNSELING CENTER, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-374-3222
Mailing Address - Street 1:PO BOX 405
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23927-0405
Mailing Address - Country:US
Mailing Address - Phone:434-374-3222
Mailing Address - Fax:434-374-3223
Practice Address - Street 1:403 VIRGINIA AVENUE
Practice Address - Street 2:SUITE F
Practice Address - City:CLARKSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23927
Practice Address - Country:US
Practice Address - Phone:434-374-3222
Practice Address - Fax:434-374-3223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003393101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty