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Organization

THE BRAIN CLINIC LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KRISTEN SMITH (CREDENTIALING SPECIALIST)
(276) 821-2260
Entity
Organization

Contact information

Practice address
188 E MAIN ST STE 1A, ABINGDON, VA 24210-2857
(276) 289-3003
(276) 289-3022
Mailing address
201 E MAIN ST STE 203, ABINGDON, VA 24210-2903
(276) 289-3003
(276) 289-3022

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
103G00000X
Clinical Neuropsychologist
Primary
103TA0700X
Adult Development & Aging Psychologist
103TB0200X
Cognitive & Behavioral Psychologist
103TC0700X
Clinical Psychologist

Other

Enumeration date
01/27/2026
Last updated
04/07/2026
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