Provider Demographics
NPI:1912592023
Name:MOUNTAINSIDE COUNSELING LLC
Entity Type:Organization
Organization Name:MOUNTAINSIDE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LEAD CLINICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:MCNEIL
Authorized Official - Last Name:LOWN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:540-742-7550
Mailing Address - Street 1:2439 FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT CRAWFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22841-2901
Mailing Address - Country:US
Mailing Address - Phone:540-742-7550
Mailing Address - Fax:855-429-4120
Practice Address - Street 1:409 VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22802-3921
Practice Address - Country:US
Practice Address - Phone:540-742-7550
Practice Address - Fax:855-429-4120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-02
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Single Specialty