Provider Demographics
NPI:1174627376
Name:COMPLETE COUNSELING SERIVCES, INC.
Entity Type:Organization
Organization Name:COMPLETE COUNSELING SERIVCES, INC.
Other - Org Name:JANIE MANTOOTH LCSW COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANIE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MANTOOTH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:540-586-8146
Mailing Address - Street 1:PO BOX 628
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24523-0628
Mailing Address - Country:US
Mailing Address - Phone:540-586-8146
Mailing Address - Fax:540-587-7647
Practice Address - Street 1:1020 TURKEY MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:VA
Practice Address - Zip Code:24523-6635
Practice Address - Country:US
Practice Address - Phone:540-586-8146
Practice Address - Fax:540-587-7647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-11
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040039791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
084297MOtherSENTARA
183482OtherANTHEM
084296MOtherSOUTHERN BEHAVIORAL HEALT
VA010219779Medicaid
233212OtherCOMPSYCH CORP
010219779OtherVIRGINIA PREMEIR
2278616OtherFIRST HEALTH
338400OtherVALUE OPTIONS
2119434OtherMAMSI
344311OtherMANAGED HEALTH NETWORK
7664336OtherAETNA
338400OtherVALUE OPTIONS