Provider Demographics
NPI:1982878336
Name:ADULT & CHILD - FAMILY COUNSELING INC
Entity Type:Organization
Organization Name:ADULT & CHILD - FAMILY COUNSELING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:TAYLOR
Authorized Official - Last Name:ELY
Authorized Official - Suffix:
Authorized Official - Credentials:RN CNS
Authorized Official - Phone:540-674-4506
Mailing Address - Street 1:PO BOX 1183
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:VA
Mailing Address - Zip Code:24084-1183
Mailing Address - Country:US
Mailing Address - Phone:540-674-4506
Mailing Address - Fax:540-674-4507
Practice Address - Street 1:125 BROAD ST
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:VA
Practice Address - Zip Code:24084-3201
Practice Address - Country:US
Practice Address - Phone:540-674-4506
Practice Address - Fax:540-674-4507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0015-000533101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010146917Medicaid
VA000001C67Medicare PIN