Provider Demographics
NPI:1215655808
Name:CENTRAL VA PEER SUPPORT SERVICES
Entity type:Organization
Organization Name:CENTRAL VA PEER SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO /MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:RCPRS
Authorized Official - Phone:540-256-6706
Mailing Address - Street 1:1506 LAXTON RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-2520
Mailing Address - Country:US
Mailing Address - Phone:540-256-6706
Mailing Address - Fax:540-900-0962
Practice Address - Street 1:1506 LAXTON RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-2520
Practice Address - Country:US
Practice Address - Phone:540-256-6706
Practice Address - Fax:540-900-0962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-18
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No172A00000XOther Service ProvidersDriverGroup - Single Specialty