| Avail Outpatient Counseling Llc | |
|
6523 Centralia Rd Chesterfield VA 23832-6587 | |
| (804) 214-2260 | |
| Not Available |
| Full Name | Avail Outpatient Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 6523 Centralia Rd, Chesterfield, Virginia |
| Authorized Official Name and Position | Shawnrell Denise Blackwell (OWNER) |
| Authorized Official Contact | 8042142260 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Avail Outpatient Counseling Llc 901 Liverpool Cir Apt 202 Chester VA 23836-2729 Ph: (804) 586-5679 | Avail Outpatient Counseling Llc 6523 Centralia Rd Chesterfield VA 23832-6587 Ph: (804) 214-2260 |
| NPI Number | 1881147627 |
|---|---|
| Provider Enumeration Date | 07/28/2016 |
| Last Update Date | 07/28/2016 |
| Medicare PECOS PAC ID | 5597046532 |
|---|---|
| Medicare Enrollment ID | O20170105000341 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881147627 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 0904008953 (Virginia) | Primary |
| Provider Name | Tangee G Moore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700273299 PECOS PAC ID: 3577844513 Enrollment ID: I20170105000407 |
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