Provider Demographics
NPI:1710770938
Name:COUNTRY HEART FAMILY THERAPY
Entity type:Organization
Organization Name:COUNTRY HEART FAMILY THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEANNE
Authorized Official - Middle Name:R
Authorized Official - Last Name:QUESENBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:276-733-1071
Mailing Address - Street 1:159 PIONEER CIR
Mailing Address - Street 2:
Mailing Address - City:HILLSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24343-4248
Mailing Address - Country:US
Mailing Address - Phone:276-733-1071
Mailing Address - Fax:
Practice Address - Street 1:159 PIONEER CIR
Practice Address - Street 2:
Practice Address - City:HILLSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24343-4248
Practice Address - Country:US
Practice Address - Phone:276-733-1071
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty