Organization
ASHBY GAP PSYCHIATRIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK PAUL DE VILLIER MSW, LPC (CHIEF FINANCIAL OFFICER)
(843) 209-2067
Entity
Organization
Contact information
Practice address
119 THE PLAINS RD, SUITE 300, MIDDLEBURG, VA 20117
(540) 326-4536
Mailing address
PO BOX 915, MIDDLEBURG, VA 20118
(540) 326-4536
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
701004712
VA
Other
Enumeration date
07/29/2015
Last updated
07/29/2015
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