Lake Country Counseling LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904006071 Issued in VA

Legal business name

LAKE COUNTRY COUNSELING LLC

Practice address

516 W Atlantic St
South Hill, VA 23970-1906

Phone

(434) 774-7559

Fax

(434) 447-3579

NPI assigned

Nov 13, 2017

Organization subpart

No

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

Authorized official

Name

Tessie S Smith, LCSW

Title

Lic Clinical Social Worker

Phone

(434) 774-7559

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tessie Smith Sadler, LCSW

  • Clinical Social Worker
  • South Hill, VA
  • NPI 1184792384
  Medicare reassignment

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

{
    "created_epoch": "1510531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510531200000",
    "number": "1871006817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 W ATLANTIC ST",
            "city": "SOUTH HILL",
            "state": "VA",
            "postal_code": "239701906",
            "telephone_number": "434-774-7559",
            "fax_number": "434-447-3579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 W ATLANTIC ST",
            "city": "SOUTH HILL",
            "state": "VA",
            "postal_code": "239701906",
            "telephone_number": "434-774-7559",
            "fax_number": "434-447-3579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE COUNTRY COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-13",
        "last_updated": "2017-11-13",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "TESSIE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "LIC CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "434-774-7559",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904006071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sindhuja Koppu
• Rothea Kornelius, PT
• Amy Lacks, FNP-BC
• Lake Country Area Agency on Aging
• Lake Country Area Agency on Aging
• Lake Country Surgical, PLC
• Lakeside Medical Associates PC
• Laura Smith, LPC Dba Windham Counseling Services LLC
• Kedar Sudhakar Lavingia
• Sabrina Leicht, PA-C

• Clinical Social Worker in South Hill, VA
• Providers in South Hill, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.