Provider Demographics
NPI:1881742427
Name:APPALACHIAN CLINICAL ASSOCIATES P.C.
Entity type:Organization
Organization Name:APPALACHIAN CLINICAL ASSOCIATES P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:CHIGLINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:540-772-0690
Mailing Address - Street 1:3247 ELECTRIC RD
Mailing Address - Street 2:SUITE 1-A
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-6448
Mailing Address - Country:US
Mailing Address - Phone:540-772-0690
Mailing Address - Fax:540-772-0692
Practice Address - Street 1:3247 ELECTRIC RD
Practice Address - Street 2:SUITE 1-A
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-6448
Practice Address - Country:US
Practice Address - Phone:540-772-0690
Practice Address - Fax:540-772-0692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040018681041C0700X
VA0810001715103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA386002OtherANTHEM
VA277637OtherANTHEM