Provider Demographics
NPI:1437801719
Name:SACRED DREAMS BIBLICAL & SECULAR COUNSELING CENTER LLC
Entity Type:Organization
Organization Name:SACRED DREAMS BIBLICAL & SECULAR COUNSELING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:NIELSEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC/LMHC/NBCC/MS
Authorized Official - Phone:571-268-6751
Mailing Address - Street 1:100 NICHOLAS DR TRLR 4939
Mailing Address - Street 2:
Mailing Address - City:CLIFTON FORGE
Mailing Address - State:VA
Mailing Address - Zip Code:24422-1969
Mailing Address - Country:US
Mailing Address - Phone:571-268-6751
Mailing Address - Fax:833-788-0610
Practice Address - Street 1:100 NICHOLAS DR TRLR 4939
Practice Address - Street 2:
Practice Address - City:CLIFTON FORGE
Practice Address - State:VA
Practice Address - Zip Code:24422-1969
Practice Address - Country:US
Practice Address - Phone:571-268-6751
Practice Address - Fax:833-788-0610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)