| Season Childress Lpc Llc | |
|
400 Roanoke St Christiansburg VA 24073-3139 | |
| (540) 392-5374 | |
| Not Available |
| Full Name | Season Childress Lpc Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 400 Roanoke St, Christiansburg, Virginia |
| Authorized Official Name and Position | Season Childress (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 5403925374 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Season Childress Lpc Llc 106 S Franklin St Ste A-1 Christiansburg VA 24073-3547 Ph: (540) 392-5374 | Season Childress Lpc Llc 400 Roanoke St Christiansburg VA 24073-3139 Ph: (540) 392-5374 |
| NPI Number | 1215549977 |
|---|---|
| Provider Enumeration Date | 08/23/2020 |
| Last Update Date | 07/09/2024 |
| Certification Date | 03/26/2024 |
| Medicare PECOS PAC ID | 7416472253 |
|---|---|
| Medicare Enrollment ID | O20250415001196 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215549977 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Season Childress |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679088918 PECOS PAC ID: 8325563166 Enrollment ID: I20250415001359 |
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