Provider Demographics
NPI:1871043588
Name:LONELY PIG COUNSELING & CONSULTING
Entity Type:Organization
Organization Name:LONELY PIG COUNSELING & CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHIATRIC NURSE PRACTITIONE
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CASEBOLT
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, BC
Authorized Official - Phone:434-315-0386
Mailing Address - Street 1:PO BOX 668
Mailing Address - Street 2:
Mailing Address - City:FARMVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23901-0668
Mailing Address - Country:US
Mailing Address - Phone:434-315-0386
Mailing Address - Fax:
Practice Address - Street 1:200 NORTH ST
Practice Address - Street 2:
Practice Address - City:FARMVILLE
Practice Address - State:VA
Practice Address - Zip Code:23901-1314
Practice Address - Country:US
Practice Address - Phone:434-315-0386
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024167534363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty