Provider Demographics
NPI:1952999377
Name:HALFWILD COUNSELING LLC
Entity Type:Organization
Organization Name:HALFWILD COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:SIGNORELLI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:804-994-1897
Mailing Address - Street 1:13364 VERDON RD
Mailing Address - Street 2:
Mailing Address - City:RUTHER GLEN
Mailing Address - State:VA
Mailing Address - Zip Code:22546-2248
Mailing Address - Country:US
Mailing Address - Phone:804-994-1897
Mailing Address - Fax:
Practice Address - Street 1:210 S RAILROAD AVE STE G
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:VA
Practice Address - Zip Code:23005-2090
Practice Address - Country:US
Practice Address - Phone:804-994-1897
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-03
Last Update Date:2021-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health