Organization
SOUTHWESTERN VIRGINIA COUNSELING AND PSYCHOLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT W SMITH PH.D. (OWNER)
(276) 228-6900
Entity
Organization
Contact information
Practice address
1035 W MAIN ST STE A, WYTHEVILLE, VA 24382-2106
(276) 228-6900
(276) 228-6910
Mailing address
1035 W MAIN ST STE A, WYTHEVILLE, VA 24382-2106
(276) 228-6900
(276) 228-6910
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
179557
ANTHEM PROVIDER LEGACY
VA
01
—
179565
ANTHEM PROVIDER LEGACY
VA
Enumeration date
10/25/2006
Last updated
08/22/2020
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