Mignone, Fred Richard
Mignone, Fred Richard is an individual health care provider with primary practice located at 159 Walters Dr , Christiansburg VA 24073-1041. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Mignone, Fred Richard can be contacted via phone (540) 381-3101.Contact Information
Primary practice address
159 Walters Dr
Christiansburg VA 24073-1041
Phone: (540) 381-3101
Fax: (540) 381-3105
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 0904005115 | Virginia |
Profile Details
| NPI number | 1538131446 |
|---|---|
| LBN Legal business name | Mignone, Fred Richard |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 3rd, 2006 |
| Last updated | Apr 10th, 2017 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1538131446 | NPPES |
| Virginia | MEDICAID | 008942455 | |
| Virginia | Other | 515460 | |
| Virginia | Other | 2116435 | |
| Virginia | Other | 455673000 | |
| Virginia | Other | 436723 | |
| Virginia | Other | 7819434 |
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