Provider Demographics
NPI:1013785245
Name:RESTORING MINDS THERAPY, LLC
Entity Type:Organization
Organization Name:RESTORING MINDS THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TERI
Authorized Official - Middle Name:
Authorized Official - Last Name:DAHLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LSATP
Authorized Official - Phone:276-207-8519
Mailing Address - Street 1:11401 ROBINSON HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:COEBURN
Mailing Address - State:VA
Mailing Address - Zip Code:24230-5017
Mailing Address - Country:US
Mailing Address - Phone:276-207-8519
Mailing Address - Fax:
Practice Address - Street 1:11401 ROBINSON HOLLOW RD
Practice Address - Street 2:
Practice Address - City:COEBURN
Practice Address - State:VA
Practice Address - Zip Code:24230-5017
Practice Address - Country:US
Practice Address - Phone:276-207-8519
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty