Provider Demographics
NPI:1962169722
Name:ASPEN VALLEY COUNSELING SERVICES PLLC
Entity type:Organization
Organization Name:ASPEN VALLEY COUNSELING SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SAVANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC
Authorized Official - Phone:605-490-3865
Mailing Address - Street 1:17949 MAIN ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22026-8001
Mailing Address - Country:US
Mailing Address - Phone:804-603-0465
Mailing Address - Fax:
Practice Address - Street 1:17949 MAIN ST UNIT 2
Practice Address - Street 2:
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22026-8001
Practice Address - Country:US
Practice Address - Phone:804-603-0465
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-29
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty