Provider Demographics
NPI:1518067537
Name:VETERANS ADMINISTRATION
Entity Type:Organization
Organization Name:VETERANS ADMINISTRATION
Other - Org Name:REHAB COUNSELING SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:TEAM LEADER
Authorized Official - Prefix:MR
Authorized Official - First Name:LYNDON
Authorized Official - Middle Name:C
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LICSW
Authorized Official - Phone:508-856-7428
Mailing Address - Street 1:10 HAZELWOOD CT
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-1564
Mailing Address - Country:US
Mailing Address - Phone:508-222-1217
Mailing Address - Fax:508-856-7456
Practice Address - Street 1:10 HAZELWOOD CT
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-1564
Practice Address - Country:US
Practice Address - Phone:508-222-1217
Practice Address - Fax:508-222-2058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA107300261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA=========OtherSOCIAL WORKER