| Brandy Hart, Llc | |
|
5821 Staples Mill Rd Henrico VA 23228-5427 | |
| (804) 264-0966 | |
| Not Available |
| Full Name | Brandy Hart, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 5821 Staples Mill Rd, Henrico, Virginia |
| Authorized Official Name and Position | Brandy Hart Knighton (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 8042640966 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brandy Hart, Llc 5821 Staples Mill Rd Henrico VA 23228-5427 Ph: () - | Brandy Hart, Llc 5821 Staples Mill Rd Henrico VA 23228-5427 Ph: (804) 264-0966 |
| NPI Number | 1528792371 |
|---|---|
| Provider Enumeration Date | 07/15/2022 |
| Last Update Date | 09/27/2022 |
| Certification Date | 09/07/2022 |
| Medicare PECOS PAC ID | 1052788593 |
|---|---|
| Medicare Enrollment ID | O20221114000212 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528792371 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Brandy M Hart Knighton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679219851 PECOS PAC ID: 2961879408 Enrollment ID: I20221116000743 |
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