TREE OF LIFE CHRISTIAN COUNSELING AGENCY LLC NPI 1699705459

NPI Information

NPI: 1699705459
Provider Name: TREE OF LIFE CHRISTIAN COUNSELING AGENCY, LLC

Other Name: PHILICIA JEFFERSON WILSON

Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
4936 SOUTHPOINT PKWY
FREDERICKSBURG, VA
ZIP 22407
Phone: (540) 710-0520
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TREE OF LIFE CHRISTIAN COUNSELING AGENCY, LLC is a mental health counselor in Fredericksburg, VA. TREE OF LIFE CHRISTIAN COUNSELING AGENCY, LLC NPI is 1699705459. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Philicia Jefferson Wilson.

The provider's business location address is:

4936 SOUTHPOINT PKWY
FREDERICKSBURG, VA
ZIP 22407-659
Phone: (540) 710-0520
Fax: (703) 490-3544

The provider's authorized official is Philicia Jefferson .
The authorized official title is Director and has the following contact phone number (540) 710-0520.

The enumeration date for this NPI number is 7/4/2006 and was last updated on 6/19/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	831	VIRGINIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	010200113	MEDICAID	VIRGINIA
2	258225000	OTHER	VIRGINIA	MENTAL HEALTH OUTPATIENT
3	005411041	MEDICAID	VIRGINIA
4	010276128	MEDICAID	VIRGINIA
5	441462	OTHER	VIRGINIA	OUT-PATIENT MENTAL HEALTH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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