Provider Demographics
NPI:1336768159
Name:MAGNOLIA COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:MAGNOLIA COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPANGLER-DUNNING
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:434-237-4305
Mailing Address - Street 1:101 DUNCRAIG DR UNIT 104
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-5790
Mailing Address - Country:US
Mailing Address - Phone:434-237-4305
Mailing Address - Fax:434-237-4307
Practice Address - Street 1:101 DUNCRAIG DR UNIT 104
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-5790
Practice Address - Country:US
Practice Address - Phone:434-237-4305
Practice Address - Fax:434-237-4307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-12
Last Update Date:2020-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health