Provider Demographics
NPI:1659097384
Name:CENTER FOR PEDIATRIC COUNSELING
Entity Type:Organization
Organization Name:CENTER FOR PEDIATRIC COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HORTON
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:434-386-8983
Mailing Address - Street 1:2001 ENTERPRISE DR
Mailing Address - Street 2:
Mailing Address - City:FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:24551-2653
Mailing Address - Country:US
Mailing Address - Phone:434-386-8983
Mailing Address - Fax:434-319-5094
Practice Address - Street 1:2001 ENTERPRISE DR
Practice Address - Street 2:
Practice Address - City:FOREST
Practice Address - State:VA
Practice Address - Zip Code:24551-2653
Practice Address - Country:US
Practice Address - Phone:434-386-8983
Practice Address - Fax:434-319-5094
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTER FOR PEDIATRIC THERAPIES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-10-14
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty