Organization
BLUE RIDGE ALTERNATIVES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY FRANCES HENSLEE LCSW (OWNER/MANAGER)
(276) 228-8300
Entity
Organization
Contact information
Practice address
695 E MAIN ST, WYTHEVILLE, VA 24382-2034
(276) 228-8300
Mailing address
385 CHURCH ST, WYTHEVILLE, VA 24382-2621
(276) 228-8300
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904005070
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102148
ANTHEM
VA
01
—
7471563
AETNA
VA
Enumeration date
02/17/2010
Last updated
02/06/2012
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