Abingdon Christian Counseling

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0701001325 Issued in VA

Legal business name

ABINGDON CHRISTIAN COUNSELING

Practice address

274 Park St
Abingdon, VA 24212

Phone

(276) 971-9715

Fax

(276) 739-7926

NPI assigned

Jan 12, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. William B Haynes Jr., M ED LPC

Title

President

Phone

(276) 971-9715

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• William B Haynes Jr M ED LPC Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861471344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1441",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242121441",
            "telephone_number": "276-971-9715",
            "fax_number": "276-739-7926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "274 PARK ST",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "24212",
            "telephone_number": "276-971-9715",
            "fax_number": "276-739-7926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABINGDON CHRISTIAN COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAYNES",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "276-971-9715",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M ED LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701001325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5414601",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "William B Haynes Jr M ED LPC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.