Organization
ACCESS INTENSIVE COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN B FOGG MS., CSAC, LPC (CEO)
(276) 210-4618
Entity
Organization
Contact information
Practice address
705 EAST MAIN STREET, LEBANON, VA 24266
(276) 210-4618
(866) 718-7167
Mailing address
PO BOX 683, POUNDING MILL, VA 24637-0683
(276) 210-4618
(886) 671-8716
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/21/2013
Last updated
02/21/2013
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