Organization
FAMILY GUIDANCE OF VA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDERSON LANE MBA, BS, QP, CPSS (EXECUTIVE DIRECTOR)
(803) 999-0476
Entity
Organization
Contact information
Practice address
220 WINDING CANYON DR, CHARLOTTE, NC 28214-5011
(803) 999-0476
(980) 446-1340
Mailing address
220 WINDING CANYON DR, CHARLOTTE, NC 28214-5011
(803) 999-0476
(980) 446-1340
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
03/10/2022
Last updated
03/10/2022
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