| Agape Mental Health And Consulting | |
|
3095 P. S. Business Center Drive Woodbridge VA 22192 | |
| (703) 309-3031 | |
| Not Available |
| Full Name | Agape Mental Health And Consulting |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 3095 P. S. Business Center Drive, Woodbridge, Virginia |
| Authorized Official Name and Position | Fay Marshall Phillips-lesane (OWNER/THERAPIST) |
| Authorized Official Contact | 7033093031 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Agape Mental Health And Consulting Po Box 4986 Woodbridge VA 22194-4986 Ph: (703) 309-3031 | Agape Mental Health And Consulting 3095 P. S. Business Center Drive Woodbridge VA 22192 Ph: (703) 309-3031 |
| NPI Number | 1679582308 |
|---|---|
| Provider Enumeration Date | 08/05/2006 |
| Last Update Date | 11/14/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679582308 | NPI | - | NPPES |
| 008939152 | Medicaid | VA | |
| 301819 | Other | VA | AMERIGROUP |
| 110630 | Other | VA | VALUE OPTIONS |
| 187248 | Other | VA | ANTHEM BC/ BS |
| M283001 | Other | VA | CAREFIRST |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 0904003313 (Virginia) | Primary |
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