| Central Virginia Psychology Pllc | |
|
174 Hunting Green Ln Kents Store VA 23084-2284 | |
| (143) 459-1016 | |
| Not Available |
| Full Name | Central Virginia Psychology Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 174 Hunting Green Ln, Kents Store, Virginia |
| Authorized Official Name and Position | John Frederick Childress (MANAGING MEMBER) |
| Authorized Official Contact | 4345910161 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Virginia Psychology Pllc Po Box 51 Kents Store VA 23084-0051 Ph: (464) 591-0161 | Central Virginia Psychology Pllc 174 Hunting Green Ln Kents Store VA 23084-2284 Ph: (143) 459-1016 |
| NPI Number | 1407451297 |
|---|---|
| Provider Enumeration Date | 12/01/2020 |
| Last Update Date | 12/01/2020 |
| Certification Date | 12/01/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407451297 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |