| Behavior Health & Wellness Center, Llc | |
|
2025 E Main St Suite 015 Richmond VA 23223-7069 | |
| (510) 776-3984 | |
| Not Available |
| Full Name | Behavior Health & Wellness Center, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 2025 E Main St, Richmond, Virginia |
| Authorized Official Name and Position | Marlin Adili Metters (PARTNER) |
| Authorized Official Contact | 5107763984 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Behavior Health & Wellness Center, Llc 3024 Cone Manor Ln Raleigh NC 27613-6604 Ph: (510) 776-3984 | Behavior Health & Wellness Center, Llc 2025 E Main St Suite 015 Richmond VA 23223-7069 Ph: (510) 776-3984 |
| NPI Number | 1962736595 |
|---|---|
| Provider Enumeration Date | 09/29/2009 |
| Last Update Date | 06/05/2023 |
| Certification Date | 06/05/2023 |
| Medicare PECOS PAC ID | 4385988609 |
|---|---|
| Medicare Enrollment ID | O20190904002621 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962736595 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 2080P0006X | Pediatrics - Developmental - Behavioral Pediatrics | (* (Not Available)) | Secondary |
| Provider Name | Rhonda A Hamlin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548381759 PECOS PAC ID: 2668703711 Enrollment ID: I20191003003738 |
| Provider Name | Kathryn V Corson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770995334 PECOS PAC ID: 8921339078 Enrollment ID: I20191003003767 |
| Provider Name | Tanaysha Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285279257 PECOS PAC ID: 8123455987 Enrollment ID: I20200218000317 |
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