Provider Demographics
NPI:1770471583
Name:APPALACHIAN COUNSELING SERVICES ONE,INC.
Entity type:Organization
Organization Name:APPALACHIAN COUNSELING SERVICES ONE,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER /DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:L
Authorized Official - Last Name:BRADLEY JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LSATP
Authorized Official - Phone:276-873-2577
Mailing Address - Street 1:1330 2ND ST
Mailing Address - Street 2:
Mailing Address - City:RICHLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:24641-2453
Mailing Address - Country:US
Mailing Address - Phone:276-873-2577
Mailing Address - Fax:276-598-4670
Practice Address - Street 1:1330 2ND ST
Practice Address - Street 2:
Practice Address - City:RICHLANDS
Practice Address - State:VA
Practice Address - Zip Code:24641-2453
Practice Address - Country:US
Practice Address - Phone:276-873-2577
Practice Address - Fax:276-598-4670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-27
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1972892685OtherNPPES