Provider Demographics
NPI:1336388081
Name:BENEDICTINE COUNSELING SERVICES
Entity Type:Organization
Organization Name:BENEDICTINE COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SISTER GLENNA
Authorized Official - Middle Name:VIRGINIA
Authorized Official - Last Name:SMITH, OSB
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MED, EDS
Authorized Official - Phone:703-369-3800
Mailing Address - Street 1:9535 LINTON HALL RD
Mailing Address - Street 2:
Mailing Address - City:BRISTOW
Mailing Address - State:VA
Mailing Address - Zip Code:20136-1217
Mailing Address - Country:US
Mailing Address - Phone:703-369-3800
Mailing Address - Fax:703-369-3877
Practice Address - Street 1:9535 LINTON HALL RD
Practice Address - Street 2:
Practice Address - City:BRISTOW
Practice Address - State:VA
Practice Address - Zip Code:20136-1217
Practice Address - Country:US
Practice Address - Phone:703-369-3800
Practice Address - Fax:703-369-3877
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BENEDICTINE SISTERS OF VIRGINIA, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-02-19
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health