Provider Demographics
NPI:1770655409
Name:ABINGDON CENTER COUNSELING GROUP, INC.
Entity Type:Organization
Organization Name:ABINGDON CENTER COUNSELING GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V-PRES
Authorized Official - Prefix:
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:S
Authorized Official - Last Name:WARNER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:276-628-1664
Mailing Address - Street 1:PO BOX 1443
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24212-1443
Mailing Address - Country:US
Mailing Address - Phone:276-628-1664
Mailing Address - Fax:276-628-9875
Practice Address - Street 1:350 RUSSELL ROAD
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-2761
Practice Address - Country:US
Practice Address - Phone:276-628-1664
Practice Address - Fax:276-628-9875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA270245OtherMANAGED HEALTH NETWORK
VA344078OtherMAMSI OPTIMUM CHOICE
VA860436OtherSENTARA OPTIMA
VA146957000OtherMAGELLAN
VA061980OtherANTHEM BCBS
VA270245OtherMANAGED HEALTH NETWORK