Provider Demographics
NPI:1568458933
Name:DIEHL, GALEN E (LPC, LSATP)
Entity Type:Individual
Prefix:MR
First Name:GALEN
Middle Name:E
Last Name:DIEHL
Suffix:
Gender:M
Credentials:LPC, LSATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 MAIN ST STE 5
Mailing Address - Street 2:COUNSELING AND PSYCHOLOGICAL SERVICES, LLC
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-1800
Mailing Address - Country:US
Mailing Address - Phone:434-792-2277
Mailing Address - Fax:434-792-2279
Practice Address - Street 1:159 DEER RUN RD
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-2863
Practice Address - Country:US
Practice Address - Phone:434-791-4685
Practice Address - Fax:434-791-4748
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0718000151101YA0400X
VA0701002341101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)