Provider Demographics
NPI:1427596808
Name:PIONEER COUNSELING CENTER, LLC
Entity Type:Organization
Organization Name:PIONEER COUNSELING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LPC
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:JOANN
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:276-880-0025
Mailing Address - Street 1:PO BOX 395
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:VA
Mailing Address - Zip Code:24266-0395
Mailing Address - Country:US
Mailing Address - Phone:276-880-0025
Mailing Address - Fax:276-880-0036
Practice Address - Street 1:2050 PIONEER DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:VA
Practice Address - Zip Code:24266-5376
Practice Address - Country:US
Practice Address - Phone:276-880-0025
Practice Address - Fax:276-880-0036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-06
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health