Organization
HANOVER COUNSELING ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA CORSO MASOURAS LCSW (BUSINESS DIRECTOR/OWNER)
(804) 310-5351
Entity
Organization
Contact information
Practice address
7109 STUDLEY RD, MECHANICSVILLE, VA 23116-6514
(804) 310-5351
Mailing address
7109 STUDLEY RD, MECHANICSVILLE, VA 23116-6514
(804) 310-5351
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904006510
VA
Other
Enumeration date
08/12/2011
Last updated
08/12/2011
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