Clinch Valley Treatment Center

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

LVN-164X00000X Issued in VA

Legal business name

CLINCH VALLEY TREATMENT CENTER

Practice address

111 Town Hollow Road
Cedar Bluff, VA 24609

Phone

(276) 963-3554

Fax

(276) 963-4653

NPI assigned

May 3, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Karen Denise Pruitt, BS

Title

Substance Abuse Counselor

Phone

(276) 963-3554

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992927537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 TOWN HOLLOW ROAD",
            "city": "CEDAR BLUFF",
            "state": "VA",
            "postal_code": "24609",
            "telephone_number": "276-963-3554",
            "fax_number": "276-963-4653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 TOWN HOLLOW ROAD",
            "city": "CEDAR BLUFF",
            "state": "VA",
            "postal_code": "24609",
            "telephone_number": "276-963-3554",
            "fax_number": "276-963-4653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINCH VALLEY TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PRUITT",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "SUBSTANCE ABUSE COUNSELOR",
        "authorized_official_telephone_number": "276-963-3554",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "VA",
            "license": "LVN-164X00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heath Clevinger, FNP
• Tiffany Clevinger
• Clinch Professional Physician Services LLC (Clinch Valley Family Care)
• Clinch Valley Physicians Associates LLC (Clinch Valley Physicians)
• Clinch Valley Treatment Center
• Jordyn K Cole, OT
• Kathy Lee Cole, FNP-C
• Emalene C Cook, RN NP
• Sherry Lynn Cook, LPN
• Mona Melissa Cordle

• Substance Abuse Rehabilitation Facility in Cedar Bluff, VA
• Providers in Cedar Bluff, VA by specialty
• Substance Abuse Rehabilitation Facility in Virginia

• 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.