| South Central Counseling Group | |
|
1046 Main Street Dillwyn VA 23936 | |
| (434) 808-0604 | |
| (434) 808-0716 |
| Full Name | South Central Counseling Group |
|---|---|
| Speciality | Social Worker |
| Location | 1046 Main Street, Dillwyn, Virginia |
| Authorized Official Name and Position | Staci L Vinson (DIRECTOR) |
| Authorized Official Contact | 8046835306 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Central Counseling Group 977 Devon Spring Ct Charlottesville VA 22903-7833 Ph: (804) 683-5306 | South Central Counseling Group 1046 Main Street Dillwyn VA 23936 Ph: (434) 808-0604 |
| NPI Number | 1619255601 |
|---|---|
| Provider Enumeration Date | 07/26/2011 |
| Last Update Date | 07/26/2011 |
| Medicare PECOS PAC ID | 1052588563 |
|---|---|
| Medicare Enrollment ID | O20120125000117 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619255601 | NPI | - | NPPES |
| 1093004871 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 0904006760 (Virginia) | Primary |
| Provider Name | Staci Lynn Vinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669659876 PECOS PAC ID: 2961679477 Enrollment ID: I20120130000180 |
| Provider Name | Anne Hwang Blair |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396010054 PECOS PAC ID: 2860654027 Enrollment ID: I20120504000027 |
| Provider Name | Kristen Carty |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154543171 PECOS PAC ID: 2466710207 Enrollment ID: I20171227001334 |
Charlottesville League Of Therapists, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1046 Main Street, Dillwyn, VA 23936 Phone: 434-984-0023 Fax: 434-984-4852 |