Jeffery Allen Phillips, BS, CSAC
Individual provider Active NPI Counselor · Gate City, VA
NPI 1801923362 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1801923362
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- CSAC 0710101751 (VA)
- Practice address
- RR 6 Box 540
Gate City, VA 24251-9760 - Phone
- (276) 452-1142
- Fax
- (276) 452-1140
- NPI assigned
- Feb 28, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CSAC 0710101751 | VA | MD | Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | CSAC 0710101751 | VA | Yes |
Addresses
Primary practice location
RR 6 Box 540
Gate City, VA 24251-9760
Mailing address
PO Box 9054
Gray, TN 37615-9054
Phone (423) 467-3600
Other providers in Gate City, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.