| Family Counseling Of Springfield, Llc | |
|
15517 Marigold Falls Ln Haymarket VA 20169-3020 | |
| (703) 447-4007 | |
| Not Available |
| Full Name | Family Counseling Of Springfield, Llc |
|---|---|
| Speciality | Counselor |
| Location | 15517 Marigold Falls Ln, Haymarket, Virginia |
| Authorized Official Name and Position | David Barry Dolberg (PRESIDENT) |
| Authorized Official Contact | 7035691300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Counseling Of Springfield, Llc 15517 Marigold Falls Ln Haymarket VA 20169-3020 Ph: (703) 447-4007 | Family Counseling Of Springfield, Llc 15517 Marigold Falls Ln Haymarket VA 20169-3020 Ph: (703) 447-4007 |
| NPI Number | 1952585317 |
|---|---|
| Provider Enumeration Date | 12/20/2007 |
| Last Update Date | 10/16/2024 |
| Certification Date | 10/16/2024 |
| Medicare PECOS PAC ID | 6103358635 |
|---|---|
| Medicare Enrollment ID | O20241022001585 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952585317 | NPI | - | NPPES |
| 386763 | Other | VA | ANTHEM BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 0701003412 (Virginia) | Secondary |
| 1041C0700X | Social Worker - Clinical | 0904004590 (Virginia) | Secondary |
| 101Y00000X | Counselor | 0701003357 (Virginia) | Primary |
| Provider Name | Joan M Normandy-dolberg |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881747947 PECOS PAC ID: 5193257624 Enrollment ID: I20241022001673 |
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