| Family Service Of Roanoke Valley | |
|
360 Campbell Ave Sw Roanoke VA 24016-3625 | |
| (540) 563-5316 | |
| (540) 563-5254 |
| Full Name | Family Service Of Roanoke Valley |
|---|---|
| Speciality | Counselor |
| Location | 360 Campbell Ave Sw, Roanoke, Virginia |
| Authorized Official Name and Position | Linda Hentschel (CEO) |
| Authorized Official Contact | 5405635316 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Service Of Roanoke Valley 360 Campbell Ave Sw Roanoke VA 24016-3625 Ph: (540) 563-5316 | Family Service Of Roanoke Valley 360 Campbell Ave Sw Roanoke VA 24016-3625 Ph: (540) 563-5316 |
| NPI Number | 1457397457 |
|---|---|
| Provider Enumeration Date | 06/20/2006 |
| Last Update Date | 11/03/2023 |
| Certification Date | 11/03/2023 |
| Medicare PECOS PAC ID | 0941296958 |
|---|---|
| Medicare Enrollment ID | O20040423001218 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457397457 | NPI | - | NPPES |
| CC0469 | Other | VA | RAILROAD MEDICARE GROUP |
| 1457397457 | Medicaid | VA | |
| 240338 | Other | VA | ANTHEM BC/BS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| Provider Name | Donna Ray Hatchett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639346810 PECOS PAC ID: 6103845524 Enrollment ID: I20051115000827 |
| Provider Name | Rita R Cone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184686040 PECOS PAC ID: 8628255122 Enrollment ID: I20110609000824 |
| Provider Name | Avery E Kerr |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023288024 PECOS PAC ID: 2466803002 Enrollment ID: I20240109001224 |
| Provider Name | Sarah Elizabeth Harig |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689146599 PECOS PAC ID: 6305297474 Enrollment ID: I20240112003072 |
| Provider Name | Decca Taliaferro Knight |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851179337 PECOS PAC ID: 3678919057 Enrollment ID: I20240307002015 |
| Provider Name | Rachel Dix Underwood |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942039938 PECOS PAC ID: 4981135126 Enrollment ID: I20240930001236 |
| Provider Name | Elizabeth Tilley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427863984 PECOS PAC ID: 0547780710 Enrollment ID: I20250219001563 |
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