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3247 Electric Rd Suite 1-a Roanoke VA 24018-6448 | |
| (540) 772-0690 | |
| (540) 772-0692 |
| Full Name | |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 3247 Electric Rd, Roanoke, Virginia |
| Authorized Official Name and Position | Michael Anthony Chiglinsky (OWNER) |
| Authorized Official Contact | 5407720690 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3247 Electric Rd Suite 1-a Roanoke VA 24018-6448 Ph: (540) 772-0690 | 3247 Electric Rd Suite 1-a Roanoke VA 24018-6448 Ph: (540) 772-0690 |
| NPI Number | 1881742427 |
|---|---|
| Provider Enumeration Date | 01/08/2007 |
| Last Update Date | 04/30/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881742427 | NPI | - | NPPES |
| 386002 | Other | VA | ANTHEM |
| 277637 | Other | VA | ANTHEM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 0810001715 (Virginia) | Primary |
| 1041C0700X | Social Worker - Clinical | 0904001868 (Virginia) | Secondary |
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