| Angela Lynne Legrande, LPC, CPSC | |
|
20 W Bank St, Petersburg, VA 23803-3279 | |
| (804) 862-8002 | |
| (804) 294-2545 |
| Full Name | Angela Lynne Legrande |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 20 W Bank St, Petersburg, Virginia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295307312 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 070101390 (Virginia) | Secondary |
| 101YP2500X | Counselor - Professional | 0701010390 (Virginia) | Primary |
| Entity Name | District 19 Community Services Board |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225094451 PECOS PAC ID: 4082502398 Enrollment ID: O20040421001639 |
| Mailing Address | Practice Location Address |
|---|---|
| Angela Lynne Legrande, LPC, CPSC 4209 Eagle Dr, Hopewell, VA 23860-1770 Ph: (804) 433-8632 | Angela Lynne Legrande, LPC, CPSC 20 W Bank St, Petersburg, VA 23803-3279 Ph: (804) 862-8002 |
Charita Threatt, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 105 Holly Hill Dive, Petersburg, VA 23805 Phone: 804-733-8847 | |
Titoni Levon Crenshaw, QMHP, CSAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2825 S Crater Rd, Petersburg, VA 23805 Phone: 804-712-3546 | |
Alexandrea J Jackson, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 350 Poplar Dr, Petersburg, VA 23805 Phone: 804-733-6874 Fax: 804-518-1341 | |
Ebony Glynn Walker, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 350 Poplar Dr, Petersburg, VA 23805 Phone: 804-733-6874 | |
Ashely Ryan, LPC Counselor Medicare: Medicare Enrolled Practice Location: 20 W Bank St, Suite 5, Petersburg, VA 23803 Phone: 804-863-1689 | |
Mr. Ricky Terrell Norwood Jr., M.ED. Counselor Medicare: Not Enrolled in Medicare Practice Location: 1200 Harrison Creek Blvd Apt 6201, Petersburg, VA 23803 Phone: 804-861-4884 Fax: 804-862-7188 | |
Michael Anthony Thomas, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 212 N Sycamore St, Petersburg, VA 23803 Phone: 804-919-1199 |