# FAMILY GUIDANCE OF VA LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851049753
- **Authorized official:** MR. ANDERSON LANE MBA, BS, QP, CPSS (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (803) 999-0476

## Contact information

- **Practice address:** 220 WINDING CANYON DR, CHARLOTTE, NC 28214-5011
- **Practice address phone:** (803) 999-0476
- **Practice address fax:** (980) 446-1340
- **Mailing address:** 220 WINDING CANYON DR, CHARLOTTE, NC 28214-5011
- **Mailing address phone:** (803) 999-0476
- **Mailing address fax:** (980) 446-1340

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 251B00000X | Case Management Agency | — | NULL | — |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |

## Other

- **Enumeration date:** 03/10/2022
- **Last updated:** 03/10/2022