Organization
COUNTY LINE COUNSELORS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALETA GIBBS LPC, LSATP (OWNER)
(276) 790-7497
Entity
Organization
Contact information
Practice address
620 COUNTY LINE RD, BASSETT, VA 24055-5157
(276) 790-7497
Mailing address
620 COUNTY LINE RD, BASSETT, VA 24055-5157
(276) 790-7497
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
01/03/2024
Last updated
01/03/2024
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