Restoring Minds Therapy, LLC
Organization Active NPI Professional Counselor · Coeburn, VA
NPI 1013785245 · NPPES record last updated Dec 18, 2023
Key facts
- NPI
- 1013785245
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Professional Counselor 101YP2500X
- Legal business name
- RESTORING MINDS THERAPY, LLC
- Practice address
- 11401 Robinson Hollow Rd
Coeburn, VA 24230-5017 - Phone
- (276) 207-8519
- NPI assigned
- Dec 18, 2023
- Organization subpart
- No
Authorized official
- Name
- Teri Dahley, LPC, LSATP
- Title
- Administrator
- Phone
- (276) 207-8519
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240829003342 | VA | Part B Supplier - Clinic/Group Practice | 8426597758 |
Receives reassigned benefits from 1 practitioner Practice locations: Coeburn, VA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor |
101YA0400X | |||
| Professional Counselor |
101YP2500X | Yes |
Addresses
Primary practice location
11401 Robinson Hollow Rd
Coeburn, VA 24230-5017
Mailing address
11401 Robinson Hollow Rd
Coeburn, VA 24230-5017
Phone (276) 207-8519
Other providers in Coeburn, VA
- R & S Helping Hands
- Cathy D Ramey
- Christopher Jackie Ratliff
- Mark Anthony Raymond
- Thomas E Renfro
- Margaret Ann Ring
- Michael Ring
- Cara Robinson
- Sandy Ridge Rescue Squad
- Sandy Ridge Volunteer Rescue Squad
All providers in Coeburn, VA · Professional Counselor in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 18, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.