Staci Woods, LPC
Individual provider Active NPI Professional Counselor · Broadway, VA
NPI 1124804828 · NPPES record last updated Sep 7, 2023
Key facts
- NPI
- 1124804828
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 0701012837 (VA)
- Practice address
- 250 Old Mill LN
Broadway, VA 22815-2754 - Phone
- (540) 901-9000
- NPI assigned
- Sep 7, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0701012837 | VA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rooted and Restored LLC | Professional | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0701012837 | VA | Yes |
Addresses
Primary practice location
250 Old Mill LN
Broadway, VA 22815-2754
Mailing address
PO Box 536
Timberville, VA 22853-0536
Other providers in Broadway, VA
- Charles Lorell Wenger
- Brynn Whetzel
- Colleen M Whiteford
- William F Whiteford
- Erica Wojciechowski
- Yellow Cab Harrisonburg
All providers in Broadway, 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 Sep 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.