Provider Demographics
NPI:1467779843
Name:HANCOCK, /MARGO (LPC)
Entity Type:Individual
Prefix:
First Name:/MARGO
Middle Name:
Last Name:HANCOCK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 37
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:VA
Mailing Address - Zip Code:23192-0037
Mailing Address - Country:US
Mailing Address - Phone:804-883-5134
Mailing Address - Fax:
Practice Address - Street 1:17099 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:MONTPELIER
Practice Address - State:VA
Practice Address - Zip Code:23192-2549
Practice Address - Country:US
Practice Address - Phone:804-883-5134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-26
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004671101Y00000X, 101YM0800X
MDLC2434101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool