Organization
BRAMBLETON ASSESSMENT AND COUNSELING CENTER
Active
Other names
Brambleton Assessment & Counseling Center LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STEPHANIE ANN GOODBAR (OWNER)
(540) 777-7060
Entity
Organization
Contact information
Practice address
3536 BRAMBLETON AVENUE, SW, SUITE 3, ROANOKE, VA 24018
(540) 580-0975
(540) 777-5453
Mailing address
3536 BRAMBLETON AVE STE 3, ROANOKE, VA 24018-6500
(540) 777-7060
(540) 777-5453
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904001648
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
396724
ANTHEM
VA
05
—
8916641
—
VA
Enumeration date
03/19/2014
Last updated
04/18/2018
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