Provider Demographics
NPI:1174737647
Name:CHRISTIAN FAMILY COUNSELING, INC
Entity type:Organization
Organization Name:CHRISTIAN FAMILY COUNSELING, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIS
Authorized Official - Middle Name:H
Authorized Official - Last Name:GAY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LMFT
Authorized Official - Phone:5403-361-4330
Mailing Address - Street 1:305 HANSON AVE
Mailing Address - Street 2:SUTIE 170
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-3126
Mailing Address - Country:US
Mailing Address - Phone:540-361-4330
Mailing Address - Fax:540-361-4331
Practice Address - Street 1:305 HANSON AVE
Practice Address - Street 2:SUITE 170
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-3126
Practice Address - Country:US
Practice Address - Phone:540-361-4330
Practice Address - Fax:540-361-4331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0707001766251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health