Provider Demographics
NPI:1881606564
Name:BLUE RIDGE COUNSELING CENTER, PLC
Entity type:Organization
Organization Name:BLUE RIDGE COUNSELING CENTER, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:LIZER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-662-7555
Mailing Address - Street 1:335 WESTSIDE STATION DR
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2840
Mailing Address - Country:US
Mailing Address - Phone:540-662-7555
Mailing Address - Fax:540-662-9105
Practice Address - Street 1:335 WESTSIDE STATION DR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2840
Practice Address - Country:US
Practice Address - Phone:540-662-7555
Practice Address - Fax:540-662-9105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty