Organization
HARVEST COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BETHANY F MIRACLE-LARSON MA (RESIDENT IN COUNSELING)
(571) 422-0056
Entity
Organization
Contact information
Practice address
7046 LEESTONE ST, SPRINGFIELD, VA 22151-3518
(571) 422-0056
Mailing address
7046 LEESTONE ST, SPRINGFIELD, VA 22151-3518
(571) 422-0056
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
02/10/2015
Last updated
02/11/2015
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