| Blue Ridge Counseling Services, LLC | |
|
300 Patrick Ave Stuart VA 24171-0941 | |
| (276) 694-2727 | |
| (276) 694-2627 |
| Full Name | Blue Ridge Counseling Services, LLC |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 300 Patrick Ave, Stuart, Virginia |
| Authorized Official Name and Position | Sharon Grey Wilson (CEO) |
| Authorized Official Contact | 2769521756 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Ridge Counseling Services, LLC Po Box 941 Stuart VA 24171-0941 Ph: (276) 694-2727 | Blue Ridge Counseling Services, LLC 300 Patrick Ave Stuart VA 24171-0941 Ph: (276) 694-2727 |
| NPI Number | 1629217260 |
|---|---|
| Provider Enumeration Date | 02/04/2009 |
| Last Update Date | 05/19/2010 |
| Medicare PECOS PAC ID | 8426359902 |
|---|---|
| Medicare Enrollment ID | O20151229001715 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629217260 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1292-02-029 (Virginia) | Primary |
| Provider Name | Sharon Grey Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316366248 PECOS PAC ID: 9335440817 Enrollment ID: I20151229001770 |
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