Provider Demographics
NPI:1982019568
Name:LIVING WATER COUNSELING MINISTRY INC.
Entity Type:Organization
Organization Name:LIVING WATER COUNSELING MINISTRY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER- CHRISTIAN COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:VALERIE
Authorized Official - Last Name:STRICKLAND
Authorized Official - Suffix:
Authorized Official - Credentials:MS LPC CSAC
Authorized Official - Phone:276-779-5100
Mailing Address - Street 1:894 ELK SPUR RD
Mailing Address - Street 2:
Mailing Address - City:FANCY GAP
Mailing Address - State:VA
Mailing Address - Zip Code:24328-4016
Mailing Address - Country:US
Mailing Address - Phone:276-779-5100
Mailing Address - Fax:
Practice Address - Street 1:203 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HILLSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24343-1432
Practice Address - Country:US
Practice Address - Phone:276-779-5100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005403251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health