Organization
PHOENIX COUNSELINGGROUP AND PLAY THERAPYCENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS ROBERT MCCRACKEN LPC (CEO)
(571) 237-4556
Entity
Organization
Contact information
Practice address
7051 HEATHCOTE VILLAGE WAY STE 125, GAINESVILLE, VA 20155-3198
(571) 237-4556
(833) 702-9006
Mailing address
7051 HEATHCOTE VILLAGE WAY STE 125, GAINESVILLE, VA 20155-3198
(571) 237-4556
(833) 702-9006
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701004422
VA
Other
Enumeration date
06/02/2016
Last updated
07/08/2024
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