49D2261131 CLIA NUMBER - COUNSEL CONNECT LLC

Laboratory Demographics

CLIA Number: 49D2261131

Facility Name: COUNSEL CONNECT LLC

Facility Address:
3604 E RIVER ROAD
ETTRICK, VA
ZIP 23803
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Facility Phone Number: 804 898-3800

Facility Type: Other - BEHAVIORAL HLTH AGENCY

Certificate Type: Waiver

NPI Number: 1407312820

Taxonomy: 251S00000X - Community/Behavioral Health
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

CLIA Record

Field Name	Field Value
CLIA Number	49D2261131
LAB Type	Other - BEHAVIORAL HLTH AGENCY
Facility Name	COUNSEL CONNECT LLC
Street	3604 E RIVER ROAD
City	ETTRICK
State	VA
ZIP	23803
Phone	804 898-3800
CertificateType	4
CertificateEffectiveDate	5/26/2022
CertificateExpirationDate	5/25/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024