Organization
C'VILLE COUNSELING & OUTPATIENT THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA RENE MANNERS LPC (CEO)
(276) 870-7757
Entity
Organization
Contact information
Practice address
175 S PANTOPS DR, ROOM 101, CHARLOTTESVILLE, VA 22911-8610
(276) 870-7757
Mailing address
5 LONGWOOD PL, PALMYRA, VA 22963-2850
(434) 207-3615
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0701005612
VA
Other
Enumeration date
09/19/2016
Last updated
09/27/2016
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