Organization
HEARTSPACE COUNSELING, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN L. WILEY LPC, RPT-S (OWNER/DIRECTOR)
(505) 920-6554
Entity
Organization
Contact information
Practice address
2502 BROADWAY AVE SW UPPR UNIT, ROANOKE, VA 24014-1663
(540) 929-1909
(877) 775-8177
Mailing address
2502 BROADWAY AVE SW UPPR UNIT, ROANOKE, VA 24014-1663
(540) 929-1909
(877) 775-8177
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03871347
—
NM
Enumeration date
04/12/2019
Last updated
04/12/2019
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