Provider Demographics
NPI:1366656191
Name:ART THERAPY & COUNSELING SERVICES, PLC
Entity Type:Organization
Organization Name:ART THERAPY & COUNSELING SERVICES, PLC
Other - Org Name:THERAPY & COUNSELING CENTER FOR CHILDREN & ADULTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:HARRIS
Authorized Official - Last Name:VANOVER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:276-698-3410
Mailing Address - Street 1:966 W MAIN ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210-2483
Mailing Address - Country:US
Mailing Address - Phone:276-698-3410
Mailing Address - Fax:276-698-3411
Practice Address - Street 1:966 W MAIN ST
Practice Address - Street 2:SUITE 4
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-2483
Practice Address - Country:US
Practice Address - Phone:276-698-3410
Practice Address - Fax:276-698-3411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904006487251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1366656191Medicaid
VA1366656191Medicaid