| A Step To Healing | |
|
116 Independence Ct Suffolk VA 23434-2369 | |
| (757) 359-8144 | |
| Not Available |
| Full Name | A Step To Healing |
|---|---|
| Speciality | Counselor |
| Location | 116 Independence Ct, Suffolk, Virginia |
| Authorized Official Name and Position | Candice Tanya Douglas (OWNER) |
| Authorized Official Contact | 7573598144 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| A Step To Healing 116 Independence Ct Suffolk VA 23434-2369 Ph: (757) 359-8144 | A Step To Healing 116 Independence Ct Suffolk VA 23434-2369 Ph: (757) 359-8144 |
| NPI Number | 1285351130 |
|---|---|
| Provider Enumeration Date | 10/21/2022 |
| Last Update Date | 10/21/2022 |
| Certification Date | 10/21/2022 |
| Medicare PECOS PAC ID | 7517305592 |
|---|---|
| Medicare Enrollment ID | O20240410001115 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285351130 | NPI | - | NPPES |
| 1962007740 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Candice Caddle |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962007740 PECOS PAC ID: 0244678233 Enrollment ID: I20240410001204 |
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